Hardin Memorial Health
Job Details: Associate's Degree RN Required The Nurse Auditor will have full responsibility to audit patient charts (i.e., medical record) upon request from Payor's on-site auditors, Patient Accounting, Risk Management, Revenue Cycle, and other network hospital entities needing completion of audit for reasons of treatment, payment or operations.\u00a0The audit is conducted to ensure that the clinical documentation contained within the patient chart supports items and services that appear on the patient's bill, and to ensure that all items and services provided are included on the patient bill. Where clinical documentation does not support items appearing on the bill, the Nurse Auditor will prepare a report of exceptions and offer solutions. Additionally, the Nurse Auditor will work with the Compliance Officer to develop, control and implement a yearly OIG internal audit plan.The Nurse Auditor will also be responsible for conducting and reporting out of all RAC audit requests. The Nurse Auditor will ensure complete and timely responses to the requestor of the audit. Responses to audits may come in the form of verbal exit conferences and\/or a written exchange of findings. QUALIFICATIONS: Associate's degree in Nursing required; Bachelor of Science in Nursing preferred. Registered Nurse licensed in Kentucky.3 years' experience in hospital setting preferred.Auditing experience preferred. Knowledge of CPT\/HCPCS procedural coding and Charge Description Masters strongly preferred. Experience with PCs, word processing, spreadsheet, graphics, and database software applications is desired. Previous auditing experience preferred.Ability to work independently, efficiently and accurately prioritizing varying workloads required.Strong quantitative, analytical, and organization skills required. Must be able to understand all ancillary department functions.Must be able to understand insurance terms (i.e. HMO\/PP, EOB, stop loss, etc.) and payment methodologies.Excellent communication skills to deal effectively with the public, department staff, hospital staff, and medical staff required.Positive attitude to work effectively with department staff required.
Hardin Memorial Health