RN Compliance, Charge Capture Auditor

Job not on LinkedIn

🔥 6 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $28 - $49 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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👻 Ghost score 0%

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Carle Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1946

⚕️ Healthcare Insurance

🏥 Healthcare

📚 Education

Healthcare Insurance • Healthcare • Education

Carle Health is a comprehensive healthcare provider dedicated to managing the health needs of its community. Offering a wide range of services, from general medical care to specialized treatments in oncology, cardiovascular, pediatrics, and women's health, Carle Health emphasizes quality patient care and community health initiatives. Additionally, it supports education and research through the Carle Illinois College of Medicine and engages in community health programs that aim to improve overall well-being.

📋 Description

• Audit accounts prior to billing according to coding, regulatory, and payer policy guidelines • Address debit and credit charging errors to ensure correct final bills • Audit documentation to verify chart documentation matches patient account charges • Perform daily audits of Inpatient, Observation, ED, and Outpatient Infusion accounts • Analyze Observation account hours and validate compliance with regulations • Submit non-billable Observation hours requiring manual carve-out to the Revenue Integrity Charge Capture Specialist team • Add IV infusion and injection charges according to CMS guidelines • Track and trend charge anomalies and report findings to clinical department directors • Provide ad hoc training and retraining to clinical staff • Contact department directors or managers to validate charges and ensure missing documentation is completed • Plan, coordinate, and conduct audits, internal control evaluations, and reviews with Revenue Integrity leadership • Present project results to the leadership team • Maintain knowledge of clinical documentation standards and charge-related regulations

🎯 Requirements

• Licensed Registered Professional Nurse (RN) from the Illinois Department of Financial and Professional Regulation (IDFPR) • Bachelor's Degree in Nursing • Knowledge of clinical documentation standards and charge-related regulations and standards • Ability to apply payer and regulatory requirements to ensure charges are accurate and supportable • Ability to manage large complex projects • Ability to investigate and analyze issues at a high level with strong attention to detail • Ability to complete and/or attend assigned training and education sessions

🏖️ Benefits

• Comprehensive benefits package • Equal Opportunity Employer • E-Verify participation