Senior Nurse Auditor, Part Time

Massachusetts General Hospital; Somerville (MA); Remote; USD 78,000 - 114,000; Part time

Job summary

A leading healthcare institution is seeking a Senior Clinical Nurse Auditor to enhance revenue integrity through clinical audits and improve financial performance. The role requires strong analytical skills and communication abilities, along with a Bachelor’s degree in Accounting and preferred nursing credentials. This part-time position offers remote work options and flexible scheduling.

Benefits

Flexible work hours

Remote work opportunities

Comprehensive benefits

Career advancement programs

Qualifications

• 3-5 years of auditing experience in the healthcare industry required.
• Registered Nurse (RN) State License preferred.
• Ability to interact with all levels of healthcare personnel.

Responsibilities

• Lead clinical audits to improve revenue integrity.
• Implement best practice charge capture processes.
• Collaborate with clinical departments on revenue cycle integrity.

Skills

Strong interpersonal and communication skills

Analytical skills

Organizational skills

Problem-solving and critical thinking

Ability to perform clinical charge audits

Ability to build collaborative work relationships

Education

Bachelor's Degree Accounting

Tools

Microsoft Office Suite

Epic

Job description

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

The Senior Clinical Nurse Auditor has a vital role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to payment for services rendered. The Senior Clinical Nurse Auditor leads clinical audits to support the organization's overall revenue integrity by implementing best practice charge capture processes to support the organization's financial performance and ensure compliance with federal and state regulatory requirements. Under limited supervision from the Manager, Revenue Integrity or other more senior Revenue Integrity leaders, the Senior Clinical Nurse Auditor is responsible for the facilitation of Revenue Integrity initiatives involving multiple clinical departments and practices focusing on revenue cycle integrity. The Senior Clinical Nurse Auditor applies a variety of continuous improvement and process improvement initiatives collaborating with individuals and teams from project conception to implementation of process improvement initiatives. Project work may include technical analyses or may require facilitation of a large multi-disciplinary group of administrators and/or medical personnel.

Qualifications

Education
Bachelor's Degree Accounting required or Bachelor's Degree Related Field of Study required

Licenses and Credentials
Registered Nurse [RN - State License] - Generic - HR Only preferred Certified Inpatient Coder [CIC] - American Academy of Professional Coders (AAPC) preferred Certified Professional Coder [CPC] - American Academy of Professional Coders (AAPC) preferred Certified Professional Coder-Hospital [CPC-H] - American Academy of Professional Coders (AAPC) preferred Certified Coding Specialist [CCS] - American Health Information Management Association (AHIMA) preferred Registered Health Information Technician [RHIT] - American Health Information Management Association (AHIMA) preferred

Experience
Auditing experience in the healthcare industry 3-5 years preferred or Auditing experience 3-5 years required

Knowledge, Skills and Abilities

• Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, well-developed analytic and organizational skills.
• Strong oral and written communication skills
• Strong complex problem solving, and critical thinking skills required.
• Strong knowledge of clinical care processes and documentation.
• Strong character, credibility, ethics, and integrity.
• Strong organizational and time management skills.
• Ability to perform and manage clinical charge audits by comparing medical record documentation to charges captured and identify opportunities for improved revenue capture and/or compliance with regulatory requirements.
• Ability to research coding and regulatory requirements required.
• Ability to interact and garner trust with various levels of staff in the organization, particularly management and senior leadership by providing practical, sound, accurate and timely support.
• Ability to review and interpret clinical data to determine whether the services are well supported in the documentation.
• Ability to interact with all levels of health care personnel and hospital/finance management.
• Ability to work independently in a role that requires flexibility in an environment that is deadline driven.
• Ability to research applicable CMS regulations, MGB charging policies and payer medical and reimbursement policies.
• Flexibility, innovation, and creativity are necessary characteristics of the successful candidate.
• Experience with computer software programs such as Microsoft Office Suite (PPT, Word, Excel, etc.) and Epic.
• Demonstrated success in building and maintain collaborative work relationships, internally, and externally, across a diverse set of organizations and/or functions.
• Adept at project planning / management, with the ability to effectively prioritize, delegate, and monitor.
• Individual is expected to continuously learn and apply new continuous improvement methodologies, and to spread successful innovation through the enterprise.

Additional Job Details (if applicable)

This is a part-time role, with 2 available schedules:

- 3 days a week, 24 hours

- 2 days a week, 16 hours

The schedule must be between M-F, 8 AM-5 PM EST, and open availability to attend team meetings.

This role is fully remote.

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

16

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$78,000.00 - $113,453.60/Annual

Grade

7

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.