[Hiring] RN Nurse Auditor @Ochsner Health

Role Description

This job performs proactive/prospective audits, retrospective/defense audits, and both targeted and ad hoc charge capture audits. Works in conjunction with clinical personnel during all audits and schedules, prepares action plans, and reports out during the Chart Audit Committee. Assists, advises, and provides expert consultation with the clinical departments to ensure all charges and medical documentation are appropriate and complete for health information management (HIM) and billing purposes. Assists in special projects and conducts internal training to ensure competency and compliance in all aspects of the revenue cycle.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Qualifications

• Required: Graduate of an accredited school of nursing.
• Preferred: Master’s degree in finance, accounting, business/health administration, nursing or related field.

Requirements

• Required: 5 years of related healthcare experience, OR 3 years of related healthcare experience with a master's degree.
• Required: Current registered nurse (RN) license in state of practice.
• Preferred: Related professional certification.

Knowledge Skills and Abilities (KSAs)

• Proficiency in using computers, software, and web-based applications.
• Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
• Excellent written and verbal communication skills.
• Strong conflict resolution skills.
• Strong presentation skills.
• Ability to work a flexible work schedule (e.g. 24/7, weekend, holiday, on call availability) and travel throughout and between facilities.

Job Duties

• Performs defensive and charge capture auditing functions.
• Handles all aspects of the Chart Audit Committee.
• Communicates audit results with all applicable stakeholders.
• Resolves all assigned pre-bill and post bill edit questions.
• Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.
• Performs other related duties as required.

Physical and Environmental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.
• Normal routine involves no exposure to blood, body fluid or tissue, but exposure or potential for exposure may occur.
• The incumbent works with patients who have known or suspected communicable diseases and may enter isolation rooms.
• The incumbent has an occupational risk for exposure to all communicable diseases.
• There may be occupational risk for exposure to hazardous medications or hazardous waste within the environment.

Equal Opportunity Employer

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Vermont, Washington, and Washington D.C.

Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or [email protected]. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.