(RN) Registered Nurse - Clinical Pre-Bill Auditor - Home Health Charlotte- Part Time
Company: Atrium Health
Location: Charlotte
Posted on: January 26, 2023
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Job Description:
Job Summary
Supports the pre-billing review of claims for all payors to ensure
that appropriate, compliant and timely billing occurs for assigned
branch locations. Conducts both clinical and/or technical audits as
prescribed by branch policy & procedure and as directed by
leadership. Maintains current knowledge on billing compliance
requirements for payors. Provides organizational and branch
leadership with timely reports, updates and recommendations for
educational opportunities as it relates to audit outcomes. Acts as
the liaison with the Branch Leadership and Billing Dept. and
participates in regularly established communication/meetings with
the branch to ensure timely month-end close.
Essential Functions
* Performs pre-bill auditing workflow per service line to ensure
all branch issues are worked timely and accurately.
* Runs assigned pre-bill reports and monitors indicators for trends
and barriers to meeting agency billing metrics.
* Stays current in EMR system and identifies system issues,
processes and/or opportunities for enhancements to ensure accurate
and efficient billing.
* Stays current with all general payor requirements for compliant
billing practices as well as state and federal regulations.
* Compiles and provides reports from clinical audit outcomes
monthly for quarterly review with Operations.
* Participates in Billing/Operations and/or Compliance meetings as
requested.
* Provides activities/action items to improve team member
engagements, supports cultural diversity and an open work
environment of positive interdepartmental communication.
Physical Requirements
Works in an office environment. Requires long periods of sitting
and computer work. May periodically drives to and from branches
and/or regional meetings in varied weather and traffic
conditions.
Education, Experience and Certifications
Graduate of an accredited school of nursing required. BSN required.
RN candidates for external hire or internal promotion without BSN
must be enrolled in a BSN program within one year of Hire/Transfer
date and must complete program within 3 years of enrollment in the
program. 1-year service line nursing experience required. 2-3 years
auditing/healthcare reimbursement experience preferred. Strong
computer skills, proficient in Microsoft applications, ability to
problem solve, analyze and communicate effectively, critical
thinking skills. Work related to healthcare compliance preferred.
Coding experience preferred. Current RN license or temporary
license as a Registered Nurse Petitioner in the state in which you
work and reside or; if declaring a National License Compact (NLC)
state as your primary state of residency, meet the licensure
requirements in your home state; or for Non-National License
Compact states, current RN license or temporary license as a
Registered Nurse Petitioner required in the state where the RN
works. Additional education, training, certifications, or
experience may be required within the department by the nurse
leader.
Keywords: Atrium Health, Charlotte , (RN) Registered Nurse - Clinical Pre-Bill Auditor - Home Health Charlotte- Part Time, Accounting, Auditing , Charlotte, North Carolina
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