Nurse Auditor Revenue Integrity (Remote)

TL;DR

Nurse Auditor Revenue Integrity (Remote): Coordinating revenue integrity/charge-related denials with Patient Business Service center, ensuring compliant clinical documentation, assisting with denials and audits, and identifying revenue optimization opportunities. Focus on performing thorough chart reviews, providing education to clinical colleagues, tracking trends, and collaborating on denial prevention processes.

Location: Remote (US, with possible travel to Michigan sites: Livonia, Farmington Hills, Howell)

Pay Range: $36.8795-$47.8193

Company

Non-profit Catholic health system committed to compassionate, person-centered care.

What you will do

• Coordinate revenue integrity and charge-related denials with Patient Business Service center.
• Perform thorough routine chart reviews and provide education to clinical colleagues on trends.
• Assist with denials, related audits, and third-party charge audits; may require travel within region.
• Track Revenue Integrity-related audits, identify trends, and report to stakeholders.
• Serve as resource for clinical information to intra/inter-departmental colleagues and payers.
• Collaborate with team on front-end processes to support denial prevention.

Requirements

• High school diploma or GED; completion of accredited program for license in applicable state(s)
• Valid driver’s license where required
• 4+ years of nursing experience
• Demonstrated knowledge of revenue cycle and denial management functions
• Knowledge of and experience in case management and utilization management
• Customer service background

Nice to have

• Registered Nurse license
• Bachelor’s degree
• 2+ years charge audit, managed care, or patient payment processing experience
• AAPC, AHIMA, CHRI certification/membership
• Outpatient CDI experience
• Working knowledge of Electronic Health Records (EHR)

Culture & Benefits

• Incorporate hirify.global Mission, Values, Vision, Actions & Promise in daily behaviors.
• Work in safe, engaging, supportive environment with responsible resource use.
• Accountable for continuous self-development and supporting others' growth.
• Adhere to federal/state laws, Integrity & Compliance Program, and Code of Conduct.
• Equal Opportunity Employer; honor dignity and unique perspectives of every person.