RN-Charge Auditor

Job Description :

The Registered Nurse – Charge Auditor plans, conducts, and performs charge audits, based on clinical documentation and billing practices for conformity with applicable regulatory requirements. Provides training and education to clinical / charging teams on appropriate documentation and charge capture processes. Identifies proactive opportunities to enhance charge capture processes, regulatory compliance and facilitates appropriate revenue capture. Coordinates and monitors charge capture projects and works closely with clinical leadership to implement best practices and ensure audit findings are addressed.

Education Qualifications :

Key Responsibilities :

Performs daily, weekly, and monthly reconciliation of technical and professional services rendered by the department providers against medical record to ensure charges posted / billed for accurate charge capture

Works with clinical departments and other impacted departments to ensure audit findings are addressed and assist in implementing best charging practices

Identifies, and analyzes billing errors and works with appropriate departments to ensure corrections are made in billing systems in a timely manner

Provides training to staff engaged in billing data entry and related charge

capture / reconciliation

activities to ensure procedures are properly documented and charges are dropped appropriately, accurately, and timely

Other duties as assigned to meet client expectations that would include root cause analysis, research of complex charging issues, implementation of corrective actions & provide subject matter expertise during system upgrades & implementations

Coordinates and reports audit outcome regarding charge errors, percentage of savings or losses, data processing errors, the performance of hospital charging system, and documentation

Provides feedback of the audit outcomes to the appropriate department to allow for process improvement

Educational Requirements :

Associate degree or bachelor's degree in nursing

Required Qualifications :

2 years of professional nursing experience

AND

2 years of work experience in healthcare coding, billing, charge capture, reimbursement

Licensure / Certification Qualifications :

Certification / Licensure Requirements :

Current licensure by the applicable state board of nursing as an RN (Registered Nurse)

Employee Benefits at Essentia Health : At Essentia Health, we're committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.

Job Location :

Business Service Center

Shift Rotation :

Day Rotation (United States of America)

Shift Start / End : 0800

1730

Hours Per Pay Period :

80

Compensation Range : Union :

FTE :

Weekends :

Call Obligations :

Sign On Bonus :