The Registered Nurse Charge Auditor plans, conducts, and performs charge audits, based on clinical documentation and billing practices for conformity with applicable regulatory requirements. Provides training and education to clinical/charging teams on appropriate documentation and charge capture processes. Identifies proactive opportunities to enhance charge capture processes, regulatory compliance and facilitates appropriate revenue capture. Coordinates and monitors charge capture projects and works closely with clinical leadership to implement best practices and ensure audit findings are addressed. Education Qualifications:
Key Responsibilities:
- Performs daily, weekly, and monthly reconciliation of technical and professional services rendered by the department providers against medical record to ensure charges posted/billed for accurate charge capture
- Works with clinical departments and other impacted departments to ensure audit findings are addressed and assist in implementing best charging practices
- Identifies, and analyzes billing errors and works with appropriate departments to ensure corrections are made in billing systems in a timely manner
- Provides training to staff engaged in billing data entry and related charge capture/reconciliation activities to ensure procedures are properly documented and charges are dropped appropriately, accurately, and timely
- Other duties as assigned to meet client expectations that would include root cause analysis, research of complex charging issues, implementation of corrective actions & provide subject matter expertise during system upgrades & implementations
- Coordinates and reports audit outcome regarding charge errors, percentage of savings or losses, data processing errors, the performance of hospital charging system, and documentation
- Provides feedback of the audit outcomes to the appropriate department to allow for process improvement
Educational Requirements:
- Associate degree or bachelors degree in nursing
Required Qualifications:
- 2 years of professional nursing experience
AND
- 2 years of work experience in healthcare coding, billing, charge capture, reimbursement
Minnesota Candidates only
Licensure/Certification Qualifications:Certification/Licensure Requirements:
- Current licensure by the applicable state board of nursing as an RN (Registered Nurse)
Job ID: 467006701
Originally Posted on: 2/26/2025
Want to find more Quality Control opportunities?
Check out the 31,227 verified Quality Control jobs on iHireQualityControl
Similar Jobs