Job Overview
Join our dynamic team as a Nurse Auditor / Revenue Integrity Charge Description Master (CDM) Analyst in a fully remote capacity, where you will play a pivotal role in enhancing healthcare billing accuracy and improving patient outcomes. This position offers an opportunity to leverage your expertise for impactful contributions while enjoying the flexibility of working from home.
Key Responsibilities
- Perform comprehensive audits of itemized charges against patient medical records and hospital documentation.
- Assign appropriate modifiers to claims and provide guidance to billing personnel regarding HCPCS codes.
- Investigate claim edits related to medical necessity and present actionable recommendations to the billing team.
- Collaborate with various revenue-generating departments to address billing inquiries and identify lost charges.
- Review documentation pertinent to observation accounts, emergency department visits, and injection/infusion charges.
- Generate detailed audit reports for finance and claims departments with recommendations for recovery.
- Educate multiple teams including claims, finance, and provider services based on audit findings.
- Analyze trends to offer process improvement suggestions to hospital departments and committees.
- Effectively communicate with both clinical and non-clinical staff, as well as patients regarding their bills.
Required Skills
- Proficient in medical coding, including familiarity with ICD-10-CM, CPT-4/HCPCS classification systems, and EMR systems.
- Nursing background with experience as an RN or LPN, particularly in charge entry or nurse auditing.
- Strong attention to detail and accuracy in sequencing diagnoses and procedures.
- Excellent problem-solving abilities with knowledge of EOB, coding denials, and hospital coding processes.
- Current CPC or equivalent certification is required.
Qualifications
- Minimum of 5 years of experience in hospital coding.
- RN or LPN credentials are preferred, especially with charge entry experience.
- Prior nurse auditing experience is a significant advantage.
Career Growth Opportunities
This role is designed to foster your professional development in a supportive environment, offering numerous avenues for career advancement and skill enhancement.
Compensation And Benefits
- Competitive hourly wage ranging from \(40.00 to \)42.00 based on your experience and expertise.
- Eligible for a comprehensive benefits package that may include:
- Medical, dental, and vision insurance.
- Critical Illness, Accident, and Hospital plans.
- 401(k) plan with pre-tax and Roth contribution options.
- Voluntary Life Insurance and AD&D coverage for you and your dependents.
- Short-term and long-term disability insurance.
- Health Spending Account (HSA).
- Transportation benefits.
- Employee Assistance Program (EAP).
- Paid Time Off (PTO), vacation, or sick leave.
If you are eager to utilize your skills to enhance healthcare billing accuracy and patient satisfaction, we invite you to apply for this rewarding opportunity.
Employment Type: Contractor
