Remote Nurse Auditor and Revenue Integrity Analyst

Description

As a Nurse Auditor/Revenue Integrity/Charge Description Master (CDM) Analyst, you will play a crucial role in ensuring healthcare billing accuracy and improving patient outcomes. Your day will involve conducting audits of itemized charges against patient medical records, advising billing staff on proper coding, and educating various teams based on audit outcomes. You will collaborate with departments to recover lost charges and analyze trends for process improvements.

Company Culture and Environment

We foster a supportive environment that values continuous improvement and teamwork. Employees enjoy a flexible work schedule and remote work options, promoting a healthy work-life balance.

Career Growth and Development Opportunities

This role offers plenty of opportunities for career growth and professional development, allowing you to enhance your skills in a dynamic healthcare setting.

Detailed Benefits and Perks

• Medical, dental, and vision insurance
• Critical Illness, Accident, and Hospital plans
• 401(k) with pre-tax and Roth contributions
• Voluntary Life Insurance and AD&D coverage for you and your dependents
• Short-term and long-term disability insurance
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program (EAP)
• Paid Time Off (PTO), vacation, or sick leave

Compensation and Benefits

Earn (40.00–)42.00 per hour for your expertise and hard work, with eligibility for benefits based on your employment classification and tenure.

Why you should apply for this position today

If you are passionate about improving healthcare billing accuracy and patient outcomes, apply today! The streamlined hiring process includes additional resume support and quick interview scheduling, making it easier for you to take the next step in your career.

Skills

• Medical Coding Proficiency: Familiarity with ICD-10-CM, CPT-4/HCPCS classification systems, and EMR systems
• Nursing Background: Experience as an RN or LPN with charge entry or nurse auditing experience
• Attention to Detail: Ability to sequence diagnoses and procedures accurately
• Problem Solving: Knowledge of EOB, coding denials, and hospital coding processes
• Certifications: Current CPC or equivalent certification required

Responsibilities

• Conduct audits of itemized charges against patient medical records
• Assign modifiers to claims and advise billing staff on HCPCS codes
• Research claim edits for medical necessity and provide recommendations
• Collaborate with departments on lost charges and billing questions
• Review documentation for observation accounts and injection/infusion charges
• Prepare written audit reports for finance and claims departments
• Educate teams based on audit outcomes
• Analyze trends for process improvement recommendations
• Communicate effectively with clinical and non-clinical staff, as well as patients

Qualifications

• At least 5 years of hospital coding experience
• RN or LPN credentials (nursing background with charge entry experience preferred)
• Nurse auditing experience is a strong plus

Education Requirements

• Relevant nursing degree or equivalent education

Education Requirements Credential Category

• Nursing License (RN or LPN)

Experience Requirements

• Minimum of 5 years in hospital coding or related experience

Why work in Chesapeake, VA

Chesapeake offers a blend of natural beauty and urban amenities, making it an ideal place to live and work. With a strong community feel, recreational activities, and proximity to other major cities, Chesapeake provides an enriching environment for both personal and professional growth.