Nurse Auditor 1

Company: Change Healthcare
Location: Jackson
Posted on: June 22, 2022

Job Description:

Overview of PositionThe Hospital Charge Audit Nurse RN/LPN will perform remote of both inpatient and outpatient hospital claims as assigned. Audits are conducted as a medical record review of all billed charges to identify over, under and late charges; as well as ensure provider reimbursement is within client guidelines and policies. These are not DRG or medical necessity audits. Employee may live in any state. What will be my duties and responsibilities in this job?+ Perform remote hospital bill charge audits as assigned while meeting department quality expectations + Manage case inventory to ensure timely scheduling of remote audits while maintaining weekly productivity goals + Ability to assess case details and provide input into audit potential of facilities & cases + Effectively interact and communicate with teammates & providers regarding all steps of the audit process. Some interaction with clients may occasionally be required as well. + Utilize nursing knowledge in conjunction with interpretation of the medical record to identify discrepancies in billed charges + Develop recommendations and possible solutions to resolve audit disputes that have resulted in incomplete audit closure + Other duties as requested What are the requirements needed for this position?+ Graduate of an accredited College or University+ Current R.N. license or LPN/LVN license+ Two years of clinical experience in an acute care hospital+ Two years medical claim review or experience as a charge audit nurse, performing Concurrent/Retrospective, Third Party Defense, Outpatient and High Dollar In Patient accounts.+ Experienced in Infusion and Injection charge hierarchy, Out Pt procedure charges and other charges related.+ Experience in use of the electronic medical record (EMR)+ Excellent organizational skills with a strong focus on attention to detail+ Knowledge of acute hospital billing requirement including UB-04s, revenue codes, itemization of charges, CPT codes, HCPCS codes ICD 10 diagnosis and procedure codes+ Proficiency with Microsoft office including Outlook, Word and Excel computer skillsWhat other skills/experience would be helpful to have?+ Medical coding credentials a plus but not required + Operating room, ICU experience and/or other critical care areas + Ability to follow up and resolve issues in a timely manner + Excellent critical thinking/problem solving skills + Excellent verbal and written communication skills to include professional communication to facilities + Ability to work independently as well as recognize when administrative or clinical support is needed + Ability to multitask in a fast-paced environment + Ability to organize, plan, prioritize and complete assignments within the required time frame + Ability to prepare clear, concise, and legible audit forms What are the working conditions and physical requirements of this job? Remote Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system! COVID Vaccination Requirements We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Equal Opportunity/Affirmative Action Statement Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to applyaccommodations@changehealthcare.com with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy. California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcares Privacy Notice to California Job Applicants Regarding the Collection of Personal Information (https://www.changehealthcare.com/privacy-notice/privacy-notice-to-california-job-applicants) . Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.

Keywords: Change Healthcare, Jackson , Nurse Auditor 1, Healthcare , Jackson, Mississippi