RN-Charge Auditor

About the position

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.

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.

Requirements

• 2 years of professional nursing experience.
• 2 years of work experience in healthcare coding, billing, charge capture, reimbursement.
• Current licensure by the applicable state board of nursing as an RN (Registered Nurse).
• Associate degree or bachelor’s degree in nursing.

Benefits

• Health Coverage: Medical, dental, vision, life and disability insurance, plus supplemental health benefit options to ensure employees' well-being.
• Retirement Savings Plans: 401(k) with employer contributions to support long-term financial security.
• Professional Development: Opportunities for career growth through training, tuition reimbursement, and educational programs.
• Work-Life Balance: Flexible scheduling, time off, holidays, and personal leave to help employees manage their professional and personal lives.
• Employee Wellness Programs: Initiatives focused on physical, mental, and emotional health, including fitness memberships, counseling services, and wellness activities.