Community Health Systems Nurse Auditor in Pennsylvania

Description:

Under the direction of the RSC VP of PFS and RSC PFS Nurse Auditors is charged with planning, organizing and executing defensive, retrospective and concurrent audits according to an audit program.

The Nurse Auditor is also responsible for Compliance reviews and audits as directed by the Ethics and Compliance Officer and/or VP of PFS and RSC PFS Directors.

The purpose of the audits is to ensure that the hospital bills only for services rendered and that all bills comply with billing requirements for government sponsored programs and other payors. The Nurse Auditor must be a resource to HIM, Business Office, Case Management and department directors for all processes in the revenue cycle. Position will also be responsible for reviewing and approving all chargemaster requests for RSC facilities.

Qualifications

Education:

Degree in healthcare or business preferred or health care knowledge equivalent. Someone with at least three years experience in a healthcare related field. Excellent interpersonal skills, must demonstrate good communication skills and the ability to work independently. Computer skills a must (i.e. Microsoft, excel, power point, etc.) Knowledge of medical terminology required.

Experience:

Revenue Integrity Analyst experience preferred. Should have a working knowledge of medical records documentation, CPT coding, HCPCS coding, DRG s, and billing compliance program rules. Should have good organizational skills, proficient with personal computers and specialized software packages.

Licenses/Certificates:

RN License

Job: Business Office

Organization: Shared Services Center - Bethlehem

Location: Pennsylvania

Requisition ID: 1803115