Remote RN Revenue Integrity Auditor (Charge/Coding)

Intermountain Healthcare Inc.; Salt Lake City (UT); Remote; USD 57,000 - 86,000; Full time

Job summary

Intermountain Healthcare Inc. is seeking a Revenue Integrity RN Charge/Coding Auditor to conduct clinical charge audits across Intermountain hospitals and clinics, reviewing denials and retrospective audits while serving as a clinical resource for Revenue Cycle departments.

The role emphasizes compliance with healthcare regulations and collaboration with multidisciplinary teams. Remote work options are available where approved, with on-site interviews possible.

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

• Use nationally recognized evidence-based utilization review criteria to determine viability for audits using supporting documentation.
• Assess the appropriateness of clinical appeal requests by identifying and analyzing payer policies and Federal/State regulations.
• Collaborate with multidisciplinary stakeholders during the audit process.
• Identify and communicate root causes for denials with members of the healthcare team.
• Serve as a subject matter expert for hospital charging, documentation requirements and medical necessity decisions.
• Support ancillary clinical-based departments as it relates to audits by research and analysis of regulatory information.
• Develop and maintain a thorough understanding of projects and assigned functions, including utilization of technology and systems.
• Complete ongoing education and CEU requirements to maintain licensure and certifications.

Skills

Collaboration

Problem solving

Critical thinking

Detail-oriented

Sound clinical judgement

Effective communication

Patient/hospital advocacy

Computer literacy

Efficiency oriented

Results Focused

Education

Registered Nurse license

Coding certification (AAPC/AHIMA)

Tools

EPIC

Microsoft Office

Electronic medical record systems

Job description

Intermountain Healthcare Inc. is seeking a Revenue Integrity RN Charge/Coding Auditor to conduct clinical charge audits across Intermountain hospitals and clinics, reviewing denials and retrospective audits while serving as a clinical resource for Revenue Cycle departments.

The role emphasizes compliance with healthcare regulations and collaboration with multidisciplinary teams. Remote work options are available where approved, with on-site interviews possible.