Remote RN Revenue Integrity Auditor

Intermountain Healthcare Inc.; San Juan (PR); Remote; USD 57,000 - 86,000; Full time

Job summary

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor for a fully remote role. The incumbent will audit clinical charges for denials review, defense audits, and retrospective reviews across Intermountain hospitals and clinics, ensuring compliance with coding and billing standards.

Requires active RN license and AAPC/AHIMA coding certification, with experience in EMR systems and revenue cycle processes. Flexible work options apply for remote candidates where approved.

Qualifications

• 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.

Responsibilities

• Assess utilization of evidence-based criteria (MCG/InterQual) for audits.
• Analyze payer policies and federal/state regulations in denials and appeals.
• Collaborate with multidisciplinary teams during audits.
• Identify root causes of denials and communicate with care teams.
• Act as SME for hospital charging, documentation, and medical necessity decisions.
• Develop guidance for policy, training, and education to reduce denials.
• Maintain understanding of projects, systems, and regulatory information.

Skills

RN license

Coding certification

MS Office

EMR systems

Healthcare revenue cycle

Education

Registered Nurse degree

Bachelor of Science in Nursing (BSN)

Tools

EPIC

Microsoft Teams

Job description

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor for a fully remote role. The incumbent will audit clinical charges for denials review, defense audits, and retrospective reviews across Intermountain hospitals and clinics, ensuring compliance with coding and billing standards.

Requires active RN license and AAPC/AHIMA coding certification, with experience in EMR systems and revenue cycle processes. Flexible work options apply for remote candidates where approved.