Nurse Auditor, Revenue Integrity

🕒 July 17

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $32 - $48 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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👻 Ghost score 55%

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Trinity Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

📚 Education

🤝 Non-profit

Healthcare • Education • Non-profit

Trinity Health is a Christian K-12 educational institution located in Wichita, Kansas, dedicated to providing a Christ-centered education that nurtures spiritual growth and academic excellence. The academy emphasizes the importance of faith in students' lives, integrating spiritual development with rigorous academic programs and a broad array of extracurricular activities, including athletics and fine arts. Trinity Health fosters a supportive community where teachers and families collaborate to help students develop a personal relationship with Jesus Christ and excel in their studies.

📋 Description

• Coordinate revenue integrity/charge-related denials with the Patient Business Service (PBS) center • Ensure compliant and complete clinical documentation • Assist with denials and related audits and identify revenue optimization opportunities • Perform thorough, routine chart reviews • Provide education to clinical colleagues and track identified trends • Leverage clinical knowledge and standard procedures to address charge-related trends promptly • Conduct retrospective charge reviews and assist with third-party charge audits • Travel between locations within the region as needed • Track Revenue Integrity-related audits, identify trends, and collaborate on education and reporting to key stakeholders • Serve as a resource contact by providing clinical information to colleagues and payers • Collaborate with the Revenue Integrity team to improve and implement front-end processes supporting denial prevention

🎯 Requirements

• High school diploma or GED • Completion of an accredited program associated with license • License in the applicable state(s) of engagement • Valid driver’s license where required by assignment • Four (4) + years of nursing experience • Demonstrated knowledge of revenue cycle & denial management functions • Knowledge of & experience in case management & utilization management • Customer service background is required • Working knowledge of Electronic Health Records (EHR), preferred • Registered Nurse, preferred • Two (2) + years of charge audit, managed care or comparable patient payment processing experience preferred • AAPC, AHIMA, CHRI certification/membership strongly preferred • Outpatient CDI experience preferred

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