[Hiring] Nurse Auditor Revenue Integrity @Trinity Health

Role Description

The Nursing Support (NS) colleague (uncertified, certified, unlicensed, or licensed) provides safe, quality health care services & / or assistance to patients under the supervision & direction of a registered nurse or other designated health care professional in accordance with level of experience, education, policies & procedures.

Essential Functions:

• Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
• Performs clinical care activities (direct or indirect) for patients within the “scope of practice” laws & training received.
• Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & flow of the care experience.
• Knows, understands & incorporates basic or essential area of practice (document, coordinate, communicate) & training standards.
• Uses clear, effective, respectful language & communication methods / means.
• Performs work in a safe, engaging, & supportive manner; influences the responsible use of resources; accountable for continuous self-development & supporting the growth of others.
• Maintains a working knowledge of applicable federal, state & local laws/regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines.

Functional Role (not inclusive of titles or advancement career progression):

• NS IV – licensed: Licensed role (direct or indirect healthcare); provides nursing interventions or clinical knowledge application in decision-making.
• Participates in the planning, implementation & / or evaluation of & solutions for care.
• Performs delegated focused / holistic care autonomously according to care plan.
• May administer medication & carry out the therapeutic treatment within scope of license (state & TH policy).
• Performs direct & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge.
• Demonstrates a level of independence to perform activities with general oversight, through personal contributions, teamwork & initiatives to safely improve outcomes.
• Advocates for patients & informs / counsels patients and families about illness & care details.
• May serve as a knowledge resource, role model & mentor or lead / coordinate / supervise direct & essential care activities or role-based service responsibilities of unlicensed / licensed / certified healthcare professionals within licensed scope of practice.

Qualifications

• High school diploma or GED.
• Completion of an accredited program associated with license.
• License in the applicable state(s) of engagement.
• Valid driver’s license where required by assignment.
• Registered Nurse, preferred.
• Training or experience according to assignment area.
• Four (4) + years of nursing experience.
• Demonstrated knowledge of revenue cycle & denial management functions.
• Knowledge of & experience in case management & utilization management.
• Customer service background is required.

Requirements

• Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell.
• Occasional exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.).
• Occasional exposure to or subject to noise, infectious waste, diseases & conditions.
• Frequent ability to follow tasks through to completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects.
• Frequent ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise.
• Continuous manual dexterity activities & / or grasping / handling.
• Occasional ability to climb, kneel, crouch & / or operate foot controls.
• Frequent use of a computer / other technology.
• Frequent ability to sit with the ability to vary / adjust physical position or activity.
• Continuous maintenance of a safe working environment & use of available personal protective equipment (PPE).
• Occasional ability to provide assistance in the event of an emergency.

Benefits

• Pay Range: $31.8795-$47.8193.