The primary purpose of this position is to perform onsite and offsite audits and provide support to the Payment Integrity office and per-diem nurse staff. The candidate for this position must be willing to perform audits within the locations listed within the job posting. The Nurse Auditor will complete audits following department guidelines and client established parameters. The Nurse Auditor must be motivated, a self-starter and able to work independently. Must actively participate with other staff as part of an effective work team.
Currently looking for:
1-full-time HBA Auditor = Compensation $70,000.00 to $80,000.00
2-Per-diem HBA Auditors = Compensation per review
Essential Function
Perform onsite and offsite audit of assigned cases comparing the I-bill to the medical record.
Review findings with hospital representative and obtains an agreement on the discrepancies.-Good rapport with hospital auditors, medicals records department and business office staff.
Identifies any hospital related issues and recommends possible solution. Will resolve when appropriate.
Acts as liaison and troubleshooter between providers and Carewise Health.
Demonstrate tact and understanding in handling problems.
Meet scheduling deadlines and completes audit reports promptly and accurately.
Follows up on audits in a timely fashion to ensure that claims are completed.
Reviews worksheets and totals by category with the bill to ensure a match.
Re-checks mathematical computations before finalizing letters and reports are forwarded to client.
Provide support and resource for other nurse auditors.
Interaction with internal Payment Integrity leadership and remote Payment Integrity offices on regular basis.
Provide support for workflow management.
Assist department with special projects as needed.
Maintains workflow and timelines for all client deliverables
All other duties as assigned.
Required Skills
Requirements
Must have a current unrestricted registered nursing license in the state of employment.
Minimum of three years hospital and ED experience.
Proficiency in Microsoft Office.
Additional training in medical terminology of related fields a plus.
Associate’s degree in nursing required.
Strong leadership skills.
An ability to communicate effectively and work with team during high-stress projects.
Ability to prioritize multiple tasks
Ability to work speedily.
Maintains open communication.
Strong verbal and written communication skills.
Required Experience
Requirements
Must have a current unrestricted registered nursing license in the state of employment.
Minimum of three years hospital and ED experience.
Proficiency in Microsoft Office.
Additional training in medical terminology of related fields a plus.
Associate’s degree in nursing required.
Strong leadership skills.
An ability to communicate effectively and work with team during high-stress projects.
Ability to prioritize multiple tasks
Ability to work speedily.
Maintains open communication.
Strong verbal and written communication skills.