Clinical Auditor RN - position will be housed in Medical Center of the Rockies (Loveland) Greeley Hospital Periop Service Support Shift: Days FTE Status: Full Time FTE: FTE: 0.80/64hr pp
Summary: Ensures that correct charges are entered for patient care services, following regulatory billing compliance guidelines. Communicates estimates of charges for services, corrects problems with billing.
Responsibilities: Ensures that correct charges are entered for patient care services. Communicates estimates of charges for services, corrects problems with billing. Reviews chart for correctness and completeness in the documentation of biologics and notifies appropriate personnel regarding any necessary corrections (according to Federal guidelines). Coordinates with Finance on perioperative services charges. Ensures charges follow regulatory compliance billing guidelines. Assists in training staff to verify and explain charges. Provides feedback and education to staff. Audits medical records to ensure compliance; notifies appropriate personnel to make any needed corrections in errors that could effect the bill. Researches lost charges and zero unbilled accounts. Researches charges to determine the cause for billing errors. Provides feedback concerning charge errors and complaints. Analyzes errors and makes suggestions for improvement. Acts as a liaison concerning billing charges. Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.
Minimum Required Education: Graduate of an accredited Registered/Professional Nursing program if less than 3 years experience. Preferred: Bachelor's degree in Nursing. Required Licensure/Certification: State licensure as a Registered Nurse (RN). Relevant certification as determined at position level. Minimum Experience: 2 years of surgical nursing experience in perioperative or surgical setting.
BLS through the American Heart Association or the American Red Cross CPR for the Professional Rescuer with card in-hand before start date. BLS or CPR card must be good through sixty days of hire. All life support certification cards must be issued by either the American Heart Association or the American Red Cross CPR for the Professional Rescuer. (American Red Cross for the Professional Rescuer is only good upon hire and all renewals will need to be through an American Heart Association sanctioned course.)
Due to Point of Care Testing duties associated with this position, upon hire, a copy of highest level of education (diploma, degree, or transcripts) would be required to present to the hiring manager. If this is available to you at this time, please attach it with your resume in one document.
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