Nurse Auditor Team Lead

7 days ago

Richmond, United States Atlantic Region CBO Full time

**Responsibilities**:
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 96,700 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

The Atlantic Region CBO is seeking a dynamic and talented Nurse Auditor Team Lead.

The Nurse Auditor Team Lead is responsible for working in conjunction with the Appeals Manager to coordinate the operational activities of the nurse auditor's workflow in the Appeals department.

**Key Responsibilities include**:

- Completes training of new hires and ongoing in-services as appropriate concerning areas of responsibility and payer specific updates.
- Serve as a support person for nurse auditors by answering questions/concerns and provide guidance on difficult clinical cases.
- Review and/or create daily, weekly and monthly reports as assigned.
- Assist department manager and assistant director with developing individual and group departmental goals and objectives
- Analyze and resolve patient claims being held by billing edits that require clinical expertise.
- Interact with Facility departments to obtain information needed to properly bill an account based on the medical record.
- Identify all coding, clinical and charging documentation issues and assist Facility departments to resolve issues.
- Review unbilled items, denial trends and high charge procedures and address issues timely and accurately.
- Serve as the liaison between the Business Office, Facility Administration and Managers about revenue and compliance issues.
- Adheres to all applicable laws, regulations and guidelines
- Completes assigned audits by analyzing information and researching documentation.
- Recommends improved workflow and makes appropriate changes based on audit findings.
- Other duties as assigned

**Benefit Highlights**
- Retention Bonus Program if offered.
- Loan Forgiveness Program if offered.
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
- Career development opportunities within UHS and its 300+ Subsidiaries

**Contact Information**:

- Nicole Baez
- HR Coordinator/Recruiter

Qualifications:
**Position Requirements**:

- RN or LPN licensure in good standing is required. BSN degree preferred
- Three to five years of experience is preferred
- CPC, CCS or other coding credentials preferred, but not required
- Experience working in Patient Financial Services and an understanding of the Revenue Cycle from beginning to end is preferred.
- Experience working in case management or audit with technical denials is required.
- Strong Microsoft Office skills (Excel, Word, Outlook)
- Customer focused both internally and externally, strong attention to detail, the ability to multi-task, strong 10 key data entry, and excellent written and oral communication skills are required.
- 1-3 years healthcare business office experience preferred.

**_
Disclaimer_**

**_
EEO Statement_**- We believe that diversity and inclusion among our teammates is critical to our success._

**_
Avoid and Report Recruitment Scams_**

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