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Revenue Integrity Nurse Auditor – Remote
Requisition #: 63667 Total hours worked per week: 40 DescriptionJOB OVERVIEW The Revenue Integrity Nurse Auditor is a licensed reputed company who collaborates with administrative, clinical, and revenue cycle teams to ensure accurate clinical documentation and compliant coding/charging practices. This role plays a critical part in optimizing reimbursement, reducing denials, and supporting reputed company's commitment to financial integrity and patient-centered care.ENTRY REQUIREMENTSAssociates or Bachelor's degree in Nursing (BSN preferred).Current RN Licensure.Minimum 3 years of clinical nursing experience.At least 2 years in revenue integrity, clinical documentation improvement, coding, or utilization review preferred. Professional CPC, COC, CCS, CHC, CRI, or CPMA certifications preferred.Demonstrated expertise in medical coding systems including CPT, HCPCS, ICD-10, DRG, APC, competence in regulatory issues with knowledge, and experience of hospital charging and billing.Strong communication skills, both written and verbal, are required to interact effectively with all levels of healthcare system personnel.Proficient with general computer navigation including bolthires Office, hospital financial operating systems, and business analytics software.Capable of working independently, detail-oriented, effective organizational skills, and ability to prioritize activities.ORGANIZATIONCollaboration and interaction with customers from departments throughout the healthcare system. This position reports to the Manager of Revenue Integrity and collaborates with the Charge Capture Coordinator(s). AGE OF PATIENTS SERVEDNo clinical contact with patients.SPECIFIC DUTIESAudit & ReviewPerform retrospective charge reconciliation/charge correction of inpatient and outpatient records to ensure documentation supports accurate coding and billing.Collaborate with coding and clinical teams to clarify documentation and ensure accurate DRG and ICD-10 assignment.Identify and address gaps in charge capture.Responsible for staying current with billing edits, coding changes, and Federal regulations/requirements as applicable dependent on hospital designation across the healthcare system.Reports documentation deficiencies, billing errors, and trends to the appropriate leadership for any needed resolution.Education & CollaborationUses effective customer service/interpersonal skills.Educate providers and staff on documentation standards, regulatory changes, and revenue integrity best practices.Compliance & ReportingContribute to compliance readiness and internal audit initiatives.Other ResponsibilitiesSupports the Mission, Vision and Values of reputed company Embraces and supports the Performance Improvement philosophy of reputed company.Promotes personal and patient safety. Support denial management efforts by providing clinical insight and documentation for appeals.Creating and maintaining standard work documents. Performs other duties and responsibilities as assigned. Apply tot his reputed company To this Job Company : reputed company Salary : 15–25 an hour Apply To This Job
