Children's Nebraska - Omaha, NE
posted 2 months ago
Full-time - Mid Level
Omaha, NE
Hospitals
About the position
The Nurse Auditor position at Children's Nebraska is responsible for auditing and reconciling hospital accounts to ensure accuracy and compliance with regulatory requirements. This role involves conducting concurrent reviews of discharges, ensuring clinical documentation supports billing, and providing education on proper billing practices. The Nurse Auditor collaborates with various departments to capture appropriate charges and addresses discrepancies in billing.
Responsibilities
- Audit and reconcile hospital accounts to medical records post-discharge.
- Conduct concurrent reviews of selected discharges, reconciling billed charges to clinical records.
- Schedule and investigate account audits requested by third parties in a timely manner.
- Review account audits with third-party representatives and negotiate settlements when necessary.
- Analyze data from reviews to identify and address inefficiencies in charge systems or workflows.
- Assist Revenue Cycle Teams with clinical documentation for payer appeals.
- Provide training and in-services to hospital staff on accurate documentation and billing practices.
Requirements
- Bachelor's Degree in nursing from an accredited college or university.
- Minimum 5 years of clinical nursing experience, preferably in intensive care or med-surg in a pediatric setting.
- Experience in hospital billing audits is required.
- Knowledge of CPT/HCPCS codes and regulatory guidelines is preferred.
Nice-to-haves
- Effective interpersonal skills for assisting and educating other departments and parents.
- Analytical skills for performing accurate audits on patient accounts.
- Proficient use of calculators and multiple systems for data retrieval.
Benefits
- Opportunities for career growth and professional development.
- Supportive and inclusive work environment.
