Remote RN Revenue Integrity Auditor

Intermountain Healthcare Inc.; Salem (OR); Remoto; USD 57.000 - 86.000; Tempo pieno

Descrizione del lavoro

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor for fully remote work. The role audits clinical charge submissions for denials reviews, defense audits, disallowed charges, and retrospective reviews, supporting revenue cycle departments with regulatory and coding guidance.

Requires RN licensure and coding certification; experience with EMR systems and databases is essential. Flexible remote work options apply where approved; onsite interviews may occur as needed.

Competenze

• Current licensure as a registered nurse.
• Current coding certification through AAPC or AHIMA.
• Experience in Microsoft Office, electronic medical record systems and electronic databases.
• Demonstrates in depth knowledge of the healthcare claim denial process.
• Demonstrates clear understanding of the healthcare revenue cycle.

Mansioni

• Use nationally recognized utilization review criteria to determine viability for audits using supporting documentation.
• Assess the appropriateness of clinical appeal requests by identifying payer policies and regulations.
• Collaborate with multidisciplinary stakeholders during the audit process.
• Identify and communicate root causes for denials with the healthcare team.
• Serve as a subject matter expert for hospital charging, documentation, clinical disease processes and medical necessity decisions.
• Develop and maintain understanding of projects and assigned functions with technology and systems.
• Complete ongoing education and CEU requirements to maintain licensure.

Conoscenze

Collaboration

Problem solving

Critical thinking

Detail-oriented

Sound clinical judgement

Effective communication

Patient/hospital advocacy

Computer literacy

Efficiency oriented

Results Focused

Formazione

RN licensure

Coding certification (AAPC/AHIMA)

Strumenti

Microsoft Office

EMR systems

Electronic databases

EPIC experience

Descrizione del lavoro

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor for fully remote work. The role audits clinical charge submissions for denials reviews, defense audits, disallowed charges, and retrospective reviews, supporting revenue cycle departments with regulatory and coding guidance.

Requires RN licensure and coding certification; experience with EMR systems and databases is essential. Flexible remote work options apply where approved; onsite interviews may occur as needed.