Compliance Nurse Specialist

2 months ago


Creve Coeur, United States Bethesda Health Full time
Bethesda Brings out the Best in Talented, Caring People

At Bethesda, more than 1,200 employees dedicate their careers to improving the lives of others.

As a team member at Bethesda, you'll enjoy great benefits such as: 403b, daily pay, bonuses, career advancement opportunities, and holiday pay.

Medical, dental, vision, prescription, and life insurance available for regular status full and part time employees.


This is a Part Time Hourly Position

Summary

Responsible for conducting audits of the medical billing documentation supporting claims billed to third parties, particularly Medicare and Medicaid. These audits determine whether services provided to residents and billed, are consistent with medical record documentation and in accordance with appropriate third-party billing regulations and/or standards. Findings are communicated to appropriate personnel. Emphasis will be placed on MDS auditing and best practices documentation. Conducts internal audits of medical documentation supporting claims billed to third parties and billing is done in accordance with appropriate third-party regulations/standards. Assists in education of clinicians and billing staff to support compliance with third party documentation and billing standards. Provides education to clinical staff in the proper use of EMR reports related to documentation in the MDS. Prepares written reports of the results of the audits and presents them to management and billing staff with recommended corrective actions. Responds to questions from nursing / billing staff regarding billing, coding and documentation. Works on joint projects with other internal compliance staff to resolve billing and documentation issues. Follows established policies and procedures, quality assurance, safety, environmental and infection control standards. Assists with periodic clinical reviews of long-term care communities in preparation for governmental or other accrediting body inspections. Assists with periodic review of Quality Measures and education of the interdisciplinary team. Monitors documentation patterns for accuracy of information through the use of reporting mechanisms within the electronic medical record software.

Job Qualifications

  • Registered nurse, bachelor degree preferred
  • Active RN license in Missouri and Illinois, or willing to obtain as soon as possible
  • Two years of Long-Term care experience, with at least one year as MDS Coordinator
  • Acute care highly desirable
  • Knowledge of Medicare and Medicaid required
  • Experience training/teaching adults preferred
  • Software skills in Word, Excel, Power Point or equivalent required
  • Basic knowledge of and experience utilizing a personal computer
  • Verbal and written communication skills
  • Excellent interpersonal and organizational skills
  • Manual dexterity, coordination and skillful use of hands for working with required equipment
  • Ability to receive and express detailed information through oral communication, visual acuity
  • Ability to read and understand written directions


Category: RN

  • Creve Coeur, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda focuses on auditing medical billing documentation to ensure compliance with third-party regulations, particularly Medicare and Medicaid. This role involves educating clinical and billing staff, preparing reports on audit findings, and working...


  • Creve Coeur, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda conducts audits of medical billing documentation to ensure compliance with Medicare and Medicaid regulations. This role involves educating clinical and billing staff, preparing audit reports, and monitoring documentation patterns for accuracy....


  • Creve Coeur, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda is responsible for auditing medical billing documentation to ensure compliance with Medicare and Medicaid regulations. This role involves educating clinical and billing staff on documentation standards, preparing audit reports, and addressing...


  • Creve Coeur, Missouri, United States Bethesda Health Full time

    RN Care Specialist at Bethesda Health Summary:The RN Care Specialist plays a pivotal role in ensuring compliance and risk management across various healthcare facilities. This position involves conducting internal audits, preparing detailed reports, and providing educational training to staff members on adherence to regulatory standards. The specialist...


  • Creve Coeur, United States Bethesda Health Full time

    Compliance Risk Specialist - RN at Bethesda Health summary: The Compliance Risk Specialist - RN is responsible for overseeing compliance and risk assessment in various health facilities, serving as a resource for staff and conducting internal audits. This role involves preparing reports for leadership, investigating serious events, and ensuring adherence...


  • creve coeur, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda focuses on auditing medical billing documentation to ensure compliance with third-party regulations, particularly Medicare and Medicaid. This role involves educating clinical and billing staff, preparing reports on audit findings, and working...


  • Creve Coeur, Missouri, United States Bethesda Health Full time

    Job Title: Healthcare Compliance SpecialistAbout Bethesda HealthBethesda Health is a leading healthcare provider dedicated to delivering high-quality patient care and improving lives. Our team of compassionate professionals strives to make a positive impact in our community.Salary: $45,000 - $60,000 per year (dependent on experience)Job Description:The...


  • creve coeur, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda conducts audits of medical billing documentation to ensure compliance with Medicare and Medicaid regulations. This role involves educating clinical and billing staff, preparing audit reports, and monitoring documentation patterns for accuracy....


  • creve coeur, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda is responsible for auditing medical billing documentation to ensure compliance with Medicare and Medicaid regulations. This role involves educating clinical and billing staff on documentation standards, preparing audit reports, and addressing...


  • Creve Coeur, United States Bethesda Health Full time

    Compliance Risk Specialist - RN at Bethesda Health summary: The Compliance Risk Specialist - RN at Bethesda is responsible for overseeing compliance and risk assessment across various healthcare facilities, including long-term care, hospice, and assisted living. This role involves conducting internal audits, preparing reports, investigating incidents,...


  • Creve Coeur, Missouri, United States Bethesda Health Full time

    Discover a rewarding career with Bethesda Health as a Healthcare Compliance Specialist.About the Role:We are seeking an experienced Registered Nurse to conduct audits of medical billing documentation, ensuring compliance with third-party regulations, particularly Medicare and Medicaid.The successful candidate will train clinical staff on documentation...


  • Creve Coeur, United States Bethesda Health Full time

    Compliance Risk Specialist - RN at Bethesda Health summary: The Compliance Risk Specialist - RN is responsible for overseeing compliance and risk management within Bethesda Health Group facilities, ensuring adherence to regulations across long-term care, hospice, and home care services. This role includes conducting internal audits, preparing reports for...


  • Creve Coeur, MO, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda focuses on auditing medical billing documentation to ensure compliance with third-party regulations, particularly Medicare and Medicaid. This role involves educating clinical and billing staff, preparing reports on audit findings, and working...


  • Creve Coeur, Missouri, United States Bethesda Health Full time

    Bethesda Health is a leading provider of healthcare services, offering a range of benefits to its employees. As an RN Compliance Specialist, you will play a critical role in ensuring the accuracy and compliance of medical billing documentation.**Job Summary**The RN Compliance Specialist will conduct audits of medical billing documentation to ensure...


  • creve coeur, United States Bethesda Health Full time

    Compliance Risk Specialist - RN at Bethesda Health summary: The Compliance Risk Specialist - RN is responsible for overseeing compliance and risk assessment in various health facilities, serving as a resource for staff and conducting internal audits. This role involves preparing reports for leadership, investigating serious events, and ensuring adherence...


  • Creve Coeur, MO, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda conducts audits of medical billing documentation to ensure compliance with Medicare and Medicaid regulations. This role involves educating clinical and billing staff, preparing audit reports, and monitoring documentation patterns for accuracy. The...


  • Creve Coeur, MO, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) at Bethesda is responsible for auditing medical billing documentation to ensure compliance with Medicare and Medicaid regulations. This role involves educating clinical and billing staff on documentation standards, preparing audit reports, and addressing...


  • creve coeur, United States Bethesda Health Full time

    Compliance Risk Specialist - RN at Bethesda Health summary: The Compliance Risk Specialist - RN is responsible for overseeing compliance and risk management within Bethesda Health Group facilities, ensuring adherence to regulations across long-term care, hospice, and home care services. This role includes conducting internal audits, preparing reports for...


  • creve coeur, United States Bethesda Health Full time

    Compliance Risk Specialist - RN at Bethesda Health summary: The Compliance Risk Specialist - RN at Bethesda is responsible for overseeing compliance and risk assessment across various healthcare facilities, including long-term care, hospice, and assisted living. This role involves conducting internal audits, preparing reports, investigating incidents,...


  • Creve Coeur, United States Bethesda Health Full time

    Bethesda Brings out the Best in Talented, Caring People! At Bethesda, more than 1,200 employees dedicate their careers to improving the lives of others. As a team member at Bethesda, you'll enjoy great benefits such as: 403b, daily pay, bonuses, career advancement opportunities, and holiday pay. Medical, dental, vision, prescription, and life insurance...