Nurse Auditor

Mercy Health - Work at Home3.6

Full-time
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Thank you for considering a career at Mercy Health!

This is what we were meant to do - Together!

Brief Description:
The Revenue Integrity RN performs all clinically related revenue integrity activities across the organization. Job duties include, but are not limited to, resolving clinically related billing errors in order to send claims to insurance companies for timely payment, acting as liaison between healthcare providers and billing department for any additional documentation needs, perform charge audits by reviewing medical documentation, identifying trends in clinical billing errors and recommendations for improvement, summarizing educational opportunities for healthcare providers based on audits, reviewing the charge description master (CDM) on a regular basis, and performing ad hoc clinical audit requests.

Mission/Core Values:
It is expected that all of the duties and responsibilities of this position will be performed in a manner consistent with the Ministry’s Standards of Behavior (CARE; Compassion: seeks to understand, listen and explain; Advocate: is the voice for the vulnerable; Respect: demonstrates the highest regard for and welcomes all people; Excellence: commits to the highest standard of quality care, joyful service, and teamwork) and in a manner that reflects our core values which are: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life and Service. All supervisors and above are expected to model the organizational mission and values through their daily actions, decision making and priority setting. All supervisors and above are expected to develop, implement and monitor short and long range plans to meet or surpass standards consistent with the overall strategic plan.

Responsibilities:
Nurse Auditor responsibilities include resolving clinically related billing errors in order to send claims to insurance companies for timely payment, acting as liaison between healthcare providers and billing department for any additional documentation needs, perform charge audits by reviewing medical documentation, identifying trends in clinical billing errors and recommendations for improvement, summarizing educational opportunities for healthcare providers based on audits, reviewing the charge description master (CDM) on a regular basis, and performing ad hoc clinical audit requests.
Performs other duties as assigned

Qualifications:
4 year Bachelor’s Degree
3-4 years experience in healthcare industry.
Experience in physician and hospital operations, compliance and provider relations preferred.
Combination of post-secondary education and experience will be considered in lieu of degree
M ercy Health is an equal opportunity employer.

We’ll also reward your hard work with:
Great health, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
An employer-matched 403(b) for those who qualify.
Paid time off
Tuition reimbursement
And a lot more

S cheduled Weekly Hours:
40

Work Shift:
Days (United States of America)

Department:
Revenue Cycle Integrity
Mercy Health provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process please contact our Human Resources Department at (513)952-5280 or by email at Recruitment@Mercy.com . This department will make sure you get connected with a Human Resources representative that can assist you.

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