Revenue Integrity Nurse Auditor - HIM Revenue Integrity
 UNC Health Care | |
 United States, North Carolina, Chapel Hill | |
 Nov 26, 2024 | |
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Job Description
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. Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. 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: 1. 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. 2. 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. 3. Audits accuracy of charges based on third party audit requests and document findings in internal audit system. 4. Utilizes clinical practices to adhere to payer regulations and reimbursement policies. 5. Identifies and troubleshoots charge issues and opportunities for charge/process enhancements. 6. Educates and trains operational areas on clinical documentation and charge-related improvements. 7. Works alongside of Revenue Integrity leaders and Chargemaster to ensure all charges are appropriately built and charged. 8. 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. 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. Other InformationJob Details Legal Employer: NCHEALTH Entity: Shared Services Organization Unit: HIM Revenue Integrity Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $27.89 - $40.09 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 their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. | |