Surgical Services Clinical Charge Audit Specialist - RN

NORTH ARKANSAS REGIONAL MEDICAL CENTER•Harrison, AR

2d•Onsite

About The Position

This role is for a Clinical Charge Audit Specialist – Registered Nurse (RN) at North Arkansas Regional Medical Center (NARMC). The position leverages surgical expertise to improve accuracy, efficiency, and patient care by ensuring surgical charges accurately reflect the care provided. It focuses on clinical charge auditing, surgical documentation, charge capture, and process improvement within Surgical Services. NARMC is committed to high-quality, compassionate healthcare, with teams working collaboratively to promote safe patient care, accountability, innovation, and excellence.

Requirements

Graduate of an accredited school of nursing.
Associate Degree in Nursing (ADN) or equivalent nursing education required.
Minimum of three (3) years of experience in Surgical Services.
Demonstrated understanding of surgical procedures, operating room workflows, and perioperative practices.
Current and unrestricted Arkansas Registered Nurse (RN) license or multistate compact license.
Current Basic Life Support (BLS) certification.
Knowledge of surgical procedures, perioperative workflows, and associated surgical supplies and implants.
Knowledge of hospital charging and reimbursement methodologies.
Understanding of clinical documentation requirements related to surgical charge capture.
Strong clinical auditing and analytical skills.
Ability to identify charging discrepancies, missed charges, duplicate charges, and opportunities for improved charge capture.
Knowledge of chargemaster maintenance principles.
Strong attention to detail and ability to analyze clinical and financial information.
Advanced Microsoft Excel skills.
Ability to communicate effectively with both clinical and non-clinical staff.
Ability to maintain confidentiality, data integrity, and accuracy.
Ability to work independently, manage multiple priorities, and drive assignments to completion.
Ability to read, write, speak, and understand English.

Nice To Haves

Bachelor of Science in Nursing (BSN).
Bachelor's degree in Business, Healthcare Administration, Nursing, Health Information Management, Finance, Accounting, or a related field.
Experience with surgical charge capture, implant charging, surgical supply utilization, clinical auditing, or healthcare reimbursement.
Experience with chargemaster maintenance.
Knowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and revenue codes.
Experience working with Revenue Cycle, Coding, Health Information Management, Finance, or Materials Management teams.
Certification such as Certified Revenue Integrity Professional (CRIP), Certified Revenue Cycle Representative (CRCR), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or another relevant healthcare revenue cycle, coding, clinical, or revenue integrity certification.
Experience with electronic health records (EHR), financial systems, materials management systems, or charge capture technology.

Responsibilities

Conduct routine clinical charge audits of surgical and perioperative cases to verify that applicable charges have been accurately captured.
Review surgical procedures, supplies, implants, and related documentation to identify missed, duplicate, incorrect, or unsupported charges.
Compare clinical documentation and surgical utilization with charges posted to identify discrepancies.
Coordinate corrective action when charge capture discrepancies are identified.
Monitor charge capture trends and identify opportunities to improve accuracy and completeness.
Identify opportunities to reduce revenue leakage through proactive clinical auditing and staff education.
Apply clinical knowledge of surgical procedures and workflows when evaluating charge accuracy.
Reconcile surgical supply and implant utilization against charges posted for individual cases.
Review preference cards and verify that associated supplies and charges accurately reflect the procedures performed.
Collaborate with Surgical Services staff and implant representatives to validate implant utilization and charging.
Work with Materials Management and Surgical Services leadership to investigate discrepancies between documented utilization and billed charges.
Review implant costs and charging practices in relation to established pricing and reimbursement requirements.
Monitor Surgical Supply Coordinator activities and provide monthly reporting on material usage, costs, savings, and identified opportunities.
Review perioperative and surgical documentation to ensure charges are accurate, complete, and clinically supported.
Validate that clinical documentation supports the charges submitted for surgical procedures, supplies, and implants.
Collaborate with Coding, Revenue Integrity, Health Information Management, and Revenue Cycle teams as needed.
Support charging practices that comply with Medicare, Medicaid, commercial payer, and applicable regulatory requirements.
Assist with preparation for internal and external audits.
Maintain confidentiality and protect the integrity of patient, clinical, and financial information.
Assist with maintenance and auditing of Surgical Services chargemaster information.
Review and update charge codes, descriptions, prices, and revenue codes associated with operating room and perioperative procedures.
Assist with maintaining accurate charging information within applicable materials management and clinical systems.
Collaborate with Revenue Cycle and Finance regarding Surgical Services chargemaster updates.
Identify opportunities to improve charge descriptions, pricing, and charge-code accuracy.
Educate Surgical Services staff regarding clinical charge capture expectations and documentation requirements.
Provide feedback to clinical teams regarding charge discrepancies and opportunities for improvement.
Assist with implementation of new charge capture processes and workflows.
Support process improvement initiatives focused on surgical charge accuracy, documentation, reimbursement, and revenue integrity.
Participate in interdisciplinary teams and projects related to Surgical Services performance and revenue cycle improvement.
Help develop sustainable processes that improve charge capture accuracy and reduce recurring discrepancies.
Serve as a clinical liaison between Surgical Services, Finance, Revenue Cycle, Coding, Materials Management, HIM, and other departments.
Build effective working relationships with nurses, surgical technologists, providers, leadership, and non-clinical partners.
Communicate audit findings and recommendations clearly to clinical and operational stakeholders.
Participate in special projects related to surgical charge capture, reimbursement optimization, supply utilization, and clinical documentation.
Perform other duties as assigned.