Nurse Auditor

Ensemble Health Partners

About The Position

The Nurse Auditor I performs charge audits and other assessments as assigned by management. This role is responsible for timely resolution of all incorrect and/or missing charges on prebill and post bill Opera reports to prevent revenue loss and ensure compliance requirements are met. Responsible for monitoring & resolving revenue loss reports, assigned work queues, and identifying opportunities for any additional documentation needs to support captured charges. Fulfill audits requests by reviewing clinical documentation, identifying trends for missing and/or incorrect charges. Applies clinical knowledge to educate stakeholders on standards for documentation and charge capture practices and to look for opportunities of improvement based on audit outcomes. Identifies opportunities for process improvements to assist clients with preventing revenue loss. Meet and/or exceeds department productivity and quality standards. Responsible for maintaining audit logs and strive for customer service excellence while meeting the mission and goals of the organization, as well as meeting all regulatory compliance requirements.

Requirements

Clinical knowledge to educate stakeholders on standards for documentation and charge capture practices.
Ability to identify opportunities for process improvements to assist clients with preventing revenue loss.
Meet and/or exceed department productivity and quality standards.
Maintain audit logs.
Strive for customer service excellence.
Meet the mission and goals of the organization.
Meet all regulatory compliance requirements.

Nice To Haves

Experience in technology-enabled revenue cycle management solutions for health systems.
Experience with hospitals and affiliated physician groups.
Experience with end-to-end revenue cycle solutions or point solutions.

Responsibilities

Performs charge audits and other assessments as assigned by management.
Responsible for timely resolution of all incorrect and/or missing charges on prebill and post bill Opera reports to prevent revenue loss and ensure compliance requirements are met.
Responsible for monitoring & resolving revenue loss reports, assigned work queues, and identifying opportunities for any additional documentation needs to support captured charges.
Fulfill audits requests by reviewing clinical documentation, identifying trends for missing and/or incorrect charges.
Applies clinical knowledge to educate stakeholders on standards for documentation and charge capture practices and to look for opportunities of improvement based on audit outcomes.
Identifies opportunities for process improvements to assist clients with preventing revenue loss.
Meet and/or exceeds department productivity and quality standards.
Responsible for maintaining audit logs and strive for customer service excellence while meeting the mission and goals of the organization, as well as meeting all regulatory compliance requirements.