[Hiring] Revenue Integrity Nurse Auditor @Trinity Health

Role Description

Responsible for coordinating revenue integrity/charge-related denials with Patient Business Service (PBS) center and ensuring compliant and complete clinical documentation.

• 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).
• Performs thorough and routine chart reviews, providing education to clinical colleagues & tracking of identified trends.
• Leverages clinical knowledge & standard procedures to ensure timely attention to charge-related trends and provides necessary education to responsible party.
• Responsible for retrospective charge reviews & assistance with third party charge audits.
• Ensures tracking of all Revenue Integrity-related audits, identifying trends & collaborating with other Revenue Integrity, PBS &/or departmental colleagues on education & reporting to key stakeholders.
• Serves as a resource contact, providing clinical information as requested by intra & inter-departmental colleagues & payers.
• Collaborates with Revenue Integrity team on opportunities to improve & implement front-end process to support denial prevention.

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.
• Four plus (4+) years of nursing experience.
• Demonstrated knowledge of revenue cycle & denial management functions.
• Knowledge of and experience in case management and utilization management.
• Customer service background is required.

Requirements

• Registered Nurse preferred.
• Bachelor's degree preferred.
• Two plus (2+) years of charge audit, managed care or comparable patient payment processing experience preferred.
• AAPC, AHIMA, CHRI certification/membership preferred.
• Outpatient CDI experience preferred.
• Working knowledge of Electronic Health Records (EHR) preferred.

Benefits

• Compensation Range: $31.8795 - $47.8193.

Company Description

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.