Auditor RN - Memorial Support Services, Full Time: Billing and Audit

Job Description:

Summary:Ensures the accuracy and integrity of medical documentation and related coding, charge capture, and billing. Detailed responsibilities:• Conducts audits of charges and related medical record documentation. Identifies errors and issues related to coding, medical necessity, charge capture, billing, documentation, and associated applications/systems.• Assists with responding to patients' inquiries concerning the accuracy of billed charges and charge descriptions.• Assists with resolving third-party payor inquiries and billing disputes, including Medicare, Medicaid and private insurance. Competencies and skills:Essential:• STANDARDS OF BEHAVIOR: Acts in a manner that supports the standards of communication, respect, privacy, and teamwork by demonstrating a commitment to professional and ethical conduct. • CUSTOMER SERVICE: Demonstrates commitment to service excellence by promptly addressing internal/external customer issues/requests, resolving concerns while maintaining a professional image and behavior to build and enhance the patient/family/customer experience.• ACCOUNTABILITY: Accepts ownership of job roles and specific assignments/goals; works independently, takes responsibility for own actions; admits mistakes and judgment errors; and accepts constructive feedback. Connects personal work results to the accomplishment of team and organizational goals.• RESPONDING TO CHANGE: Accepts change and adapts in a positive and productive manner; handles unexpected situations and changes in direction calmly and with confidence. Views new assignments and job responsibilities as an opportunity for growth.• DATA MINING, ANALYSIS & REPORTING: Collects, compiles and conducts mining and analysis of data for defined purpose.• ACCURACY: Completes work assignments within established quality and/or quantity standards. • HEALTHCARE INDUSTRY: Versed in healthcare industry's trends, directions, major issues, regulatory considerations and trendsetters. Education:Essential:• Accredited Program Education specialization:Essential:• Nursing Credentials:Essential:• Registered Nurse License Education equivalent experience:Essential:• Graduate of an accredited Professional Nursing Program Other information:Complexity of Work: Requires critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Must be able to work in a collaborative environment.Required Work Experience: 3 years clinical nursing experience in a hospital setting. Working conditions:Essential:• Keyboard Entry 80.00%• Repetitive Movement Hand/Arm 80.00%• Sitting 80.00%• Standing 80.00%• Walking 80.00%• Audible Speech 80.00%• Hearing Acuity 80.00%• Depth Perception 80.00%• Distinguish Color 80.00%• Seeing - Far 80.00%• Seeing - Near 80.00%• Computer Monitor 80.00% Organizational Profile: Memorial Healthcare System, consisting of 6 acute care hospitals, a nursing home, outpatient facilities, home health services and physician practices, provides quality, comprehensive care to the residents of the surrounding communities. We invite you to join one of the nation's leading healthcare systems, recognized for use of advanced technology and clinical informatics. Memorial Support Services provides a variety of business services to support our facilities. The main offices are located in Miramar with satellite offices located throughout our system. Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.