Nurse Auditor

As the Nurse Auditor & Hospital Coder

If you’re ready to explore the next step in your career:

You’ll enjoy…

Career Opportunities – Tons of growth opportunities for your career

Standard Hours - Monday-Friday (6:00am - 6:00pm - opportunity for an 8 hour shift between these hours of operation)

Workplace Setting – 100% Remote with location restrictions (Must be 2 and a half hours from Chesapeake, VA).

Competitive Pay - $40.00/hr

Expedited Interviews – Access to additional Resume support and pre-interview questions

A day in the role…

• Responsible for performing audits of itemized charges versus the patient medical record and other applicable hospital documentation
• Assigning modifiers to appropriate claims
• Researching edited claims for medical necessity, and advising the billing staff of appropriate HCPCS codes and modifiers
• Works directly with revenue producing departments regarding lost charges, billing questions, proper coding and charging, education on appropriate charge capture and providing CDM support
• Reviews documentation on all observation accounts for carve-out observation hours, extended recovery, the charge coding of ED visits and Injection and Infusion charges
• With direction from the Patient Financial Services Director, the Nurse Auditor/ Revenue Integrity/ CDM Analyst is responsible for performing audits of itemized charges versus the patient medical record and other applicable hospital documentation, assigning modifiers to appropriate claims, researching edited claims for medical necessity, and advising the billing staff of appropriate HCPCS codes and modifiers.
• The Nurse Auditor/ Revenue Integrity/ CDM Analyst works directly with revenue producing departments regarding lost charges, billing questions, proper coding and charging, education on appropriate charge capture and providing CDM support, research and maintenance of the Charge Description Master.
• The nurse auditor/CDM analyst reviews documentation on all Observation accounts for carve-out observation hours, extended recovery, the charge coding of ED Visits and Injection and Infusion charges.
• Receive, review, verify, and process requests for chart audits of inpatient hospitalizations, diagnostic testing, outpatient procedures and services, home health care services, durable medical equipment, rehabilitative therapies, and pharmacy reviews from finance and/or claims department
• Prepare written reports for finance and claims departments including explanations for recovery of money and appropriate regulatory agencies
• Educates provider services, claims, recovery, finance and other department staff on the outcomes of the audit results and assists provider services with educational efforts
• Provide feedback and process improvement recommendations to appropriate hospital departments and committees based on analysis and trending of hospital or provider audits
• Provide written explanations to patients who are questioning their bills. Must be able to communicate effectively verbally and in written format to clinical and non-clinical staff and individuals
• Familiar with coding diagnostic and procedural information from the record using ICD-10-CM and CPT-4/HCPCS classification systems. Utilize a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM

Necessary Skills and Strengths:

Medical Coding | Nursing Experience | Nurse Auditing | Registered Nurse | LPN | ICD-10 | EMR Systems | Medical Coding | CPC Certified | Accounts Receivable | Medical Terminology | EOB | Coding Denials | Hospital Coding

Core Experience:

·      Must have CPC or another coding certification

·      5+ years of hospital coding experience

·      RN or LPN with Charge entry experience

·      Nurse auditing experience a huge plus

Pay and Benefits

The pay range for this position is $40.00 - $42.00

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

� Medical, dental & vision

� Critical Illness, Accident, and Hospital

� 401(k) Retirement Plan � Pre-tax and Roth post-tax contributions available

� Life Insurance (Voluntary Life & AD&D for the employee and dependents)

� Short and long-term disability

� Health Spending Account (HSA)

� Transportation benefits

� Employee Assistance Program

� Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position will be accepting applications until Dec 18, 2024.

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.