Compliance Nurse Specialist

2 weeks ago

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, ensuring compliance with Medicare and Medicaid regulations. This role includes educating clinical and billing staff on documentation standards and preparing detailed reports on audit findings. The position requires an active RN license, previous experience in long-term care, and strong communication skills.

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

Keywords:

Compliance Nurse, Medical Billing Audits, Medicare, Medicaid, Healthcare Compliance, Nursing Education, Documentation Standards, Long-Term Care, MDS Coordinator, Clinical Audits

  • Compliance Nurse Specialist

    3 weeks ago

    Creve Coeur, MO, 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...

  • Compliance Nurse Specialist

    2 weeks ago

    Creve Coeur, MO, 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...

  • Compliance Nurse Specialist

    1 week ago

    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 includes educating clinical and billing staff on proper documentation practices and conducting internal audits for...

  • Compliance Nurse Specialist

    2 weeks ago

    Creve Coeur, MO, 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...

  • Compliance Nurse Specialist

    3 weeks ago

    Creve Coeur, MO, 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...

  • Compliance Nurse Specialist

    5 days ago

    Creve Coeur, MO, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) is responsible for conducting audits of medical billing documentation for third-party claims, especially Medicare and Medicaid, ensuring compliance with regulations. This part-time position involves educating clinical staff on proper documentation practices,...

  • Compliance Nurse Specialist

    3 weeks 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...

  • Compliance Nurse Specialist

    3 weeks 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...

  • Compliance Nurse Specialist

    3 weeks 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...

  • Compliance Nurse Specialist

    3 weeks 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...

  • Compliance Nurse Specialist

    2 weeks 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...

  • Medical Compliance Specialist

    7 days ago

    Creve Coeur, Missouri, United States Bethesda Health Full time

    RN Care Specialist at Bethesda HealthJob Title: Medical Compliance SpecialistCompany Overview:Bethesda Health is a leading healthcare provider with over 1,200 dedicated employees. Our mission is to deliver exceptional care and improve the lives of others.Salary:The estimated annual salary for this position is $65,000 - $85,000, depending on experience.Job...

  • Compliance Nurse Specialist

    3 weeks 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...

  • Compliance Nurse Specialist

    2 weeks ago

    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, ensuring compliance with Medicare and Medicaid regulations. This role includes educating clinical and billing staff on documentation standards and preparing detailed reports on audit...

  • Compliance Nurse Specialist

    1 week ago

    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, ensuring compliance with Medicare and Medicaid regulations. This role includes educating clinical and billing staff on documentation standards and preparing detailed reports on audit...

  • Compliance Nurse Specialist

    3 weeks 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...

  • Compliance Nurse Specialist

    3 days ago

    Creve Coeur, United States Bethesda Health Full time

    Compliance Nurse Specialist (RN) at Bethesda Health summary: The Compliance Nurse Specialist (RN) is responsible for conducting audits of medical billing documentation for third-party claims, especially Medicare and Medicaid, ensuring compliance with regulations. This part-time position involves educating clinical staff on proper documentation practices,...

  • Healthcare Compliance Specialist

    1 week ago

    Creve Coeur, Missouri, United States Bethesda Health Full time

    Bethesda Health seeks a skilled RN Care Specialist to join our team. As a registered nurse, you will conduct audits of medical billing documentation supporting claims to third parties, including Medicare and Medicaid.This role requires ensuring compliance with documentation standards and providing education to clinical and billing staff regarding best...

  • Medical Billing Compliance Specialist

    1 week ago

    Creve Coeur, Missouri, United States Bethesda Health Full time

    Bethesda Health is a leading healthcare provider dedicated to delivering exceptional patient care and improving lives. As a Medical Billing Compliance Specialist, you will play a critical role in ensuring the accuracy and integrity of our medical billing processes.Job Description:We are seeking an experienced Registered Nurse with a strong background in...

  • Medical Billing Compliance Specialist

    2 days ago

    Creve Coeur, Missouri, United States Bethesda Health Full time

    About the RoleBethesda Health is seeking a skilled Medical Billing Compliance Specialist to join our team. This part-time hourly position offers an estimated salary of $60,000 - $80,000 per year.Job SummaryThe Medical Billing Compliance Specialist will conduct audits of medical billing documentation to ensure compliance with Medicare and Medicaid standards....