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utilization management jobs near tupelo, ms

Nurse Auditor, Internal Audit

North Mississippi Medical Center -
Tupelo, MS

Apply Now

Job Details

Full-time

Benefits

403(b) matching
License reimbursement
Disability insurance
Relocation assistance
Health insurance
Dental insurance
Tuition reimbursement
Employee assistance program
Vision insurance
Employee discount
403(b)
Referral program

Qualifications

Nursing
RN License
Nursing

Full Job Description

Nurse Auditor, Internal Audit

Job ID: 000G47

Tupelo

Professionals - INTERNAL AUDIT

Full Time - Day

Posting Description

We believe a career is more than just a career — it's a calling. Our teammates' "True North" is what calls them to health care; it’s their passion. At North Mississippi Health Services, we believe in helping you leverage and connect that passion with a much greater purpose that impacts people you know and love.

Job Description

JOB SUMMARY
The Nurse Auditor at North Mississippi Health Services plays a critical role in ensuring the accuracy of medical record documentation and compliance with regulations. They conduct clinical audits, evaluate weaknesses, and make recommendations for improvement, including special projects like Drug Diversion Audits and IRB Audits.
JOB FUNCTIONS
Clinical Audits:

The incumbent's primary task is to perform audits to ensure medical record documentation accurately reflects billed charges and is in compliance with federal and state regulations. The incumbent evaluates if weaknesses exist and must be able to make recommendations to address the weaknesses. The incumbent performs special projects to include Drug Diversion Audits and IRB Audits at the request of senior leadership. Must be able to perform projects in a timely manner.
Compliance:
The incumbent is responsible for performing clinical compliance audits as needed to ensure NMHS is compliant with applicable laws and regulations. The incumbent also assists the Audit Director, and Privacy Officer in HIPAA audits.
Coordinate:
The incumbent is responsible for coordinating clinical audits and pre-audits medical record files with external parties.
Communication:

QUALIFICATIONS

Education
Bachelor's Degree in Nursing or BBA. Required Or
Associate's Degree in lieu of Bachelor degree willing to accept Assoc degree with 4 years experience beyond the required minimum. Required

Licenses and Certifications
. RN- Registered Nurse - State Licensure. Upon Hire. Required

Work Experience
1-3 years. A minimum of three years of clinical experience. Required And
1-3 years. auditing, clinical documentation improvement, coding, or utilization review. Preferred And

Knowledge Skills and Abilities
Familiarity with PC to include Word, Excel, and various internet resources
Short, specific statements about skills needed in areas of planning, organizing, implementing, and evaluating the work that is to be done.
This position is responsible for coordinating and performing clinical audits on medical record files as requested by external parties and in-house business staff.
This position also develops and performs internal departmental audits to verify charging, documentation processes, and appropriate controls.
With whom does the person come into contact and to what degree.
The individual should have strong communication skills, ability to interact with various levels of NMHS management and staff, external auditors, and other outside parties.
This position must convey a professional level of expertise and confidentiality and maintain a working relationship with all levels of management and staff.

Physical Demands

A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Standing. Occasionally
Walking. Occasionally
Sitting. Frequently
Lifting/Carrying. Occasionally 20 lbs
Pushing/Pulling. Rarely
Climbing. Rarely
Balancing. Rarely
Stooping/Kneeling/Bending. Rarely
Reaching/Over Head Work. Occasionally
Grasping. Frequently
Speaking. Frequently
Hearing. Constantly
Repetitive Motions. Frequently
Eye/Hand/Foot Coordinations. Occasionally

Benefits A****vailable
Continuing Education
403B Retirement Plan with Employer Match Contributions
Pet, Identity Theft and Legal Services Insurance
Wellness Programs and Incentives
Referral Bonuses
Employee Assistance Program
Medical Benefits
Dental Benefits
Vision Benefits
License + Certification Reimbursement
Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
Employee Discount Program
Other:
Early Access to Earned Wages
Tuition Assistance
Relocation Assistance
Paid Time Away
Special Employee Rates at NMMC Wellness Centers

Requirements

The following are requirements in addition to any stated in the above description.

Licenses

You must have the following licenses to apply:

Registered Nurse and Registered Nurse

Education

You must have the following education to apply:

Associates of Nursing

You must have a Associates or higher

Apply Now

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