Nurse Auditor Registered Nurse FT Days at AdventHealth

Date Posted: 11/14/2019

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Maitland, FL
  • Job Category
  • Date Posted:
    11/14/2019
  • Job ID:
    19022480
  • Job Family
    Managed Care
  • Travel
    No
  • Shift
    1 - Day
  • Application Zone
    1-Shared Services
  • Organization
    AdventHealth Central Florida

Job Description


Description

Nurse Auditor RN AdventHealth

 
Location Address: 900 Winderley Place

Top Reasons to work at AdventHealth Orlando

•          Located on a lush tropical campus, our flagship hospital, 1,368-bed AdventHealth Orlando

•         serves as the major tertiary facility for much of the Southeast, the Caribbean and South America

•         AdventHealth Orlando houses one of the largest Emergency Departments and largest cardiac catheterization labs in the country

•         We are already one of the busiest hospitals in the nation, providing service excellence to more than 32,000 inpatients and 125,000 outpatients each year

Work Hours/Shift:
•         Days M-F 8-5

**Ability to work remotely once training is complete**

 
You Will Be Responsible For:   

• •   Assist FH/Managed Care Department when outside agencies conduct audits involving hospital billing.

•    Work closely with FH/Managed Care department when outside agencies request chart audits.

•    When customer service complaints related to charges are received conducts research into the legitimacy of the charge

•    Logs price and billing complaints and reports results to supervisor.

•    Works closely with PFS/HIM/Finance to research and correct specific problem accounts or areas.

•    Certain charge issues that appear on the interface rejection report, SSI edits or coding software will be referred to the nurse auditor for research and possible correction.

•    When charge errors require correction by the department who generated the original charge; identifies CPA Work Item to appropriate staff or Manager.

•    May conduct ongoing departmental charge audits that are focused on checking for specific charge problem areas i.e. procedure billing of observation accounts.

•    Monitors charge accuracy levels for all revenue producing departments.

•    Conducts charge audits checking physician orders, clinical documentation and reports against billed charges.

•    Provides revenue producing departments with a report of their charge accuracy levels as requested.

•    Makes process improvement recommendations to departments that have been audited.

•    When requested, leads out in charge accuracy improvement meetings that address specific process and charge issues.

•    Charge questions that are raised by departments will be researched with the involvement of the corporate CDM/HIM/PFS departments to ensure that the issue is addressed by the proper individuals at the corporate office.

•    Utilizes the corporate charge master manual as a guide for determining the proper charge

Qualifications
 
Job Summary:
What You Will Need:
 

EDUCATION AND EXPERIENCE REQUIRED:

RN with current Florida license

3 years clinical hospital experience, CDM management, case management or order entry maintenance experience.  Knowledge of the disease process and treatment methodology is required and utilized at least 50% of the time.

 

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:

 
Current Florida License as an RN
 
Job Summary:

The Nurse Auditor will ensure that the charges that are generated in the Cerner Clinical system are being properly billed. This will be accomplished by conducting chart audits that compare charges with physician orders, clinical documentation and reports. The Nurse Auditor will work closely with Financial Services and the Patient Accounting departments to review and correct any charge errors that they find. Complex charge issues that require research may be referred to this position by HIM, PFS, Customer Service or case management. The Nurse Auditor will work closely with the FH/Managed Care department anytime there are audits requested by an insurance company. This position will be responsible for participating in and occasionally chair meetings that address process improvement initiatives related to charge accuracy levels. Responsible for auditing multiple operational areas. Provides regional coverage as required to AdventHealth Orlando.




This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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