Clinical Chart Auditor
Location: Reno Nevada
Description: Renown Health is looking of Clinical Chart Auditor right now, this career will be placed in Nevada. Detailed specification about this career opportunity please read the description below. Position Purpose:
Under the general direction of the VP of Revenue Cycle, the Chart Auditor is responsible for ensuring the accurate, timely charging and documentation of services provided to patients with! in the Renown Health facilities. The Chart Auditor is also responsible for ongoing hospital education regarding proper charging as required by government compliance, insurance companies and audit agencies. The Chart Auditor is responsible for monitoring and trending gross revenue vs. charging errors on all audits including external defense audits on accounts reviewed by insurance companies, external audit agencies, on patient requested audits, and focus, random audits of all departments.
Co-Chairs the Chart Audit Committee with the facility CFO by presenting results of internal and external audits with recommendations by department for remedial action to be taken.
Nature and Scope:
The Chart Auditor will review all accounts in preparation for requested audits and will be responsible for conducting patient requested audits to answer all questions regarding care given and charges applied to bill. The Auditor will be responsible for scheduling audits wi! th payors as requested per standard audit procedure and will e! nsuring appropriate payment has been made on the account based on verified benefits prior to audit and will coordinate all billing audit activities. The Chart Auditor will serves as the primary liaison between the hospital and the payee.
The Chart Auditor will conduct random chart audits for all facility services on a concurrent & retrospective basis and will provide feedback to all departments with errors on statistics. The auditor will review late charges by department with each department manager and will review all charging deficiencies and other areas needing improvement
The Chart Auditor will Co-Chair and coordinate the Monthly Chart Audit Meetings with the facility CFO, providing documentation for discussion at the meeting and minutes with follow-up action items. Prepares statistical reports outlining department error ratios by month for review at meeting. Ensures action plans are logged and followed.
Functions as a resource for business and clinical pers! onnel in resolving charging questions or deficiencies. Responsible for ongoing education programs re: proper charging as required by government and commercial agencies.
Work with various departments to obtain the necessary information to perform charge analysis. This includes but is not limited to, Health Information Management department, Clinical areas, Ancillary Depts, Case Managers, and Physicians. Responsible for documenting all findings in both the Financial System and internal Audit Logs. Reports any reoccurring charging issues that are identified.
Performs special projects as requested; i.e., rate comparisons, flat rate studies, and all other duties as assigned.
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualif! ications: Requirements - Required and/or Preferred
Educ! ation:
Must have working-level knowledge of the English language, including reading, writing and speaking English. Must have working-level knowledge of the English language, including reading, writing and speaking English.
- Current Nevada state RN or LPN licensure must be maintained
- A Bachelor's Degree in Nursing preferred
- Two years in hospital finance or in patient financial services with knowledge of charge description master.
- Experience in case management, managed care terms and practices, or utilization review preferred
- Demonstrated customer service orientation.
- Strong people/interpersonal skills.
- Strong organizational, problem solving and decision-making skills.
- Ability to work on multiple projects.
- Knowledge of PCs and related applications/uses such as Excel, Word, and Access etc.
- Excellent oral and written communication skills. Excellent presentation skills. Experience:
- CPT, ICD-9-CM and HCPCS experience preferred.
- Claims processing experience helpful.
- Experience in claims and medical record documentation review preferred
Ability to obtain and maintain a State of Nevada RN or LPN license. Current unrestricted license.
Certification(s):
Certification with the American Healthcare Auditors Association Preferred.
Certification in Case Management (CCM), Professional Utilization Reviewer (CPU, or Managed care (NMCC) preferred.
Computer / Typing:
Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
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If you were eligible to this career, please email us your resume, with salary r! equirements and a resume to Renown Health.
If you interested on this career just click on the Apply button, you will be redirected to the official website
This career starts available on: Fri, 19 Apr 2013 00:32:44 GMT