Address
Form of work
SalaryThe primary purpose of this per diem position is to perform both on and off site providing support to the Payment Integrity office and per-diem nurse staff. The Auditor will complete audits following department guidelines and client established parameters. The Auditor must be motivated, a self-starter and able to work independently. Must actively participate with other staff as part of an effective work team.
Essential Function
Perform onsite and offsite audit of assigned cases comparing the I-bill to the medical record.
- Review findings with hospital representative and obtains an agreement on the discrepancies.
–Updates assigned audits utilizing company provided equipment.
- Good rapport with hospital auditors, medicals records department and business office staff.
- Identifies any hospital related issues and recommends possible solution. Will resolve when appropriate.
- Acts as liaison and troubleshooter between providers and Carewise Health.
- Demonstrate tact and understanding in handling problems.
- Meet scheduling deadlines and completes audit reports based on established productivity standards.
- Follows up on audits timely based on established productivity standards.
- Reviews worksheets and totals by category with the bill to ensure a match.
- Re-checks audit mathematical computations before submitting completed audit to office and in accordance with established quality standards.
- Provide support and resource for other nurse auditors.
- Interaction with internal PI leadership and remote MBRPI auditors on regular basis.
- Provide support for workflow management.
- Assist department with special projects as needed.
- Maintains workflow and timelines for all client deliverables
- All other duties as assigned.
Required Skills
Requirements
- Must be a registered nurse with a valid license
- Associate’s degree in nursing required.
- ICU experience required
- Hospital auditing experience preferred.
- Proficiency in Excel and Word is required.
- Additional training in medical terminology of related fields a plus.
- Strong leadership skills.
- An ability to communicate effectively and work with team during high-stress projects.
- Ability to prioritize multiple tasks.
- Maintains open communication.
- Strong verbal and written communication skills.
