Nurse Auditor

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

• Assists during audits involving hospital billing. Conducts research into the legitimacy of charges.

• Logs price and billing complaints. Other duties as assigned.

• Makes process improvement recommendations to audited nursing staff. Leads charge accuracy improvement meetings addressing specific process and charge issues.

• Monitors charge accuracy levels for all revenue-producing departments.

• Investigates charge issues from interface rejection reports, SSI edits, or coding software for possible correction.

• Reviews and corrects charge errors found during audits.

• Participates in meetings focused on process improvement initiatives related to charge accuracy.

• Communicates with appropriate staff or manager when charge errors require correction by the originating department.

• Performs other duties as assigned

• Ability to interact with the Hospital Financial Department, HIM personnel, and departmental leaders. [Required]

• Knowledge of the disease process and treatment methodology is required and utilized at least 50% of the time. [Required]

• Knowledge of ICD-10 and CPT Coding Principles as well as billing methodologies. Knowledge of computer system includes Windows, Excel, Epic EMR system. Ability to communicate effectively in writing and verbally. Must have financial analysis capabilities. [Required]

• Occasional contact with patients and outsiders. Regular contact with employees. [Required]

• The Nurse Auditor has access to institutional financial goals and ongoing reports supporting the achievement and benchmarks of the Finance Committee. The Nurse Auditor has the responsibility to adhere to the AdventHealth Corporate Compliance plan, to the rules and regulations of all local, state, and Federal agencies, and to the standards of all accrediting bodies. [Required]

• Must be adaptable and flexible as required. [Required]

• Regional Travel up to 20% may be required. [Required]

• Knowledge of the disease process and treatment methodology is required and utilized at least 50% of the time. [Required]

• Associate of Nursing [Required]

• Bachelor's [Preferred]

• in Nursing, Business, Accounting, Finance, or another related field

• 3+ auditing experience either for hospitals or insurance companies or healthcare revenue cycle experience with a focus in one or more of the following areas: coding, charge integrity, charge reconciliation, charge compliance, charge auditing, cdm compliance, and hospital / professional billing. or relevant clinical hospital experience. [Preferred]

• 3+ clinical hospital experience in audit specialty hired to audit [Required]

• Case management, Utilization RN, Coding or equivalent. [Preferred]

• Epic experience [Preferred]

• N/A

• Registered Nurse (RN) [Required]

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.