RN Revenue Integrity Nurse Auditor - Revenue Integrity

UNC Health; North Carolina; A distancia; USD 40.000 - 57.000; Jornada completa

Descripción de la vacante

UNC Health in Chapel Hill, NC seeks a Revenue Integrity Nurse Auditor to audit charges system-wide, working with two RN auditors. The role supports 6a-6p, five days weekly, with fully remote coverage.

Two years nursing experience and RN licensure required; prior revenue integrity or charge code auditing preferred. Employment under NC Health, Shared Services, HIM Revenue Integrity.

Formación

• Graduate of an accredited school of nursing.
• At least two (2) years previous nursing experience.
• Prior Revenue Integrity or Charge Code Auditing experience is preferred.

Responsabilidades

• Audits hospital charges and documentation to ensure quality of care, medical necessity, and reimbursement.
• Develops understanding of application systems for clinical documentation, charging, and billing processes.
• Audits accuracy of charges based on third party audit requests and documents findings.
• Adheres to payer regulations and reimbursement policies in clinical documentation and charging.
• Identifies and troubleshoots charge issues and opportunities for improvements.
• Educates operational areas on clinical documentation and charge-related improvements.
• Collaborates with Revenue Integrity leaders and Chargemaster to ensure proper charging.
• Works with hospital departments to perform charge audits and identify opportunities.

Descripción del empleo

Description

Our department of HIM-Revenue Integrity is seeking a Revenue Integrity Nurse Auditor to facilitate charge code auditing system-wide. This role works with a team of 2 other RN charge code auditors to provide coverage 6a-6p 5 days per week; fully remote.

Prior Revenue Integrity or Charge Code Auditing experience is preferred for this role.

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina

Job Summary

Collaborates with Revenue Integrity leadership and hospital departments to ensure compliance with clinical documentation and revenue cycle billing practices.

Description Of Job Responsibilities

• Conducts audits of hospital charges and documentation using clinical expertise and billing regulations to ensure compliance with quality of care, medical necessity, and appropriate reimbursement.
• Develops full understanding of application systems and their appropriate use in the clinical documentation for charging, billing, order entry, and financial processes of UNC Health System.
• Audits accuracy of charges based on third party audit requests and document findings in internal audit system.
• Utilizes clinical practices to adhere to payer regulations and reimbursement policies.
• Identifies and troubleshoots charge issues and opportunities for charge/process enhancements.
• Educates and trains operational areas on clinical documentation and charge-related improvements.
• Works alongside of Revenue Integrity leaders and Chargemaster to ensure all charges are appropriately built and charged.
• Collaborates with appropriate hospital departments to perform requested charge audits and identify charge opportunities.

Education Requirements

Graduate of an accredited school of nursing. At least two (2) years previous nursing experience.

Licensure/Certification Requirements

RN NC LIC

Professional Experience Requirements

At least two (2) years previous nursing experience. High level of interpersonal skills and organizational abilities. Ability to work independently or on a team, and deliver exceptional, timely results.

Prior Revenue Integrity or Charge Code Auditing experience is preferred for this role.

Knowledge, Skills, And Abilities Requirements

Possesses high level of interpersonal skills and organizational abilities. Ability to deal with difficult situations and fast paced environment. ED charging/coding experience preferred.

Language Skills: Ability to read, analyze, and interpret clinical information and technical procedures. Ability to document clinical information. Ability to effectively communicate information and respond to questions from patients, physicians, family members, and other Rex staff.

Mathematical Skills: Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Reasoning Ability: Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions.

Demonstrates remarkable written and verbal communication skills, analytical expertise, and attention to detail.

Demonstrates knowledge of compliance with regulation changes and updates to clinical processes, coding guidelines, and reimbursement trends.

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: HIM Revenue Integrity

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $28.87 - $41.50 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Remote

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: No

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [e-mail] if you need a reasonable accommodation to search and/or to apply for a career opportunity.