RN Nurse Auditor
Southern Illinois Hospital ServicesCurrent SIH employees need to apply for positions through our internal job portal. Log in to Workday to apply through the Jobs Hub.
Position Summary
• Responsible for patient account accuracy through audits of charging, billing and documentation compliance with third party payor requirements, governmental regulatory agencies and SIH policies and procedures.
Principal Accountabilities
• Standards of Performance: Respect, Integrity, Compassion, Collaboration, Stewardship, Accountability, Quality
Education
• Associate’s degree in Nursing
Licenses and Certification
• Current Illinois RN Licensure
Experience and Skills
• Technical Experience: 3 years
Role Specific Responsibilities
o Performs audits comparing the medical record to the patient’s account to determine charging and billing accuracy.
o Utilizes the Nurse Audit Program for the addition, reversal, or adjustment of charges based on medical record documentation.
o Upon request of Compliance Officer, monitors use of the appropriate CPT/HCPCS codes for certain items or services with known or suspected coding, charging, documentation and/or billing concerns or specific payor requirements.
o Identifies issues related to inappropriate charging and conducts and/or participates in department or multidisciplinary training or meetings to resolve those and any other charging issues. Develops corrective action plan.
o Communicates any charge and/or billing error trends noted to the Compliance Officer, co-workers, and affected departments.
o Collaborates with the Compliance Analyst, third party auditor and others as needed in the scheduling, performance and resolution of third party audits.
o Performs or assists in Compliance audits, investigations or other special projects at the direction of the Compliance Officer.
o Perform necessary adjustments to patient accounts to meet clinical trial billing requirements.
o Collaborate with nursing, patient intake, health information, case management, and patient financial services to improve patient account documentation and assignment of the appropriate patient type and status.
Compensation (Commensurate with experience):
$63,585.60 - $98,550.40To access our Benefits Guide/Plan Information, please click the link below: