Ochsner Health-posted 9 months ago
Remote • New Orleans, LA
Ambulatory Health Care Services

This job performs proactive/prospective audits, retrospective/defense audits, and both targeted and ad hoc charge capture audits. Works in conjunction with clinical personnel during all audits and schedules, prepares action plans, and reports out during the Chart Audit Committee. Assists, advises, and provides expert consultation with the clinical departments to ensure all charges and medical documentation are appropriate and complete for health information management (HIM) and billing purposes. Assists in special projects and conducts internal training to ensure competency and compliance in all aspects of the revenue cycle. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

  • Performs defensive and charge capture auditing functions.
  • Handles all aspects of the Chart Audit Committee.
  • Communicates audit results with all applicable stakeholders.
  • Resolves all assigned pre-bill and post bill edit questions.
  • Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.
  • Performs other related duties as required.
  • Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.
  • Graduate of an accredited school of nursing.
  • 5 years of related healthcare experience, OR 3 years of related healthcare experience with a master's degree.
  • Current registered nurse (RN) license in state of practice.
  • Master's degree in finance, accounting, business/health administration, nursing or related field.
  • Related professional certification.
  • Ochsner Health is an Equal Opportunity Employer.
  • All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
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