Charge Integrity Nurse Auditor

Charge Integrity Nurse Auditor job in Albuquerque, NM

Shift: 1st - Day
Schedule: Full Time

You’re going to LOVE Lovelace!

About us: Lovelace Shared Services: Organizational support departments for all Lovelace facilities including Coding, Finance, Health Information Management, Revenue Cycle, Marketing, and the Resource Team.  We are dedicated to exceeding our customers’ expectations in every way.

Lovelace Shared Services is now hiring a Charge Capture Nurse Auditor.

  • The Charge Capture Nurse Auditor performs reviews for charge integrity to include audit of the following: medical record documentation (EMR) to support clinical and financial outcomes, revenue cycle processes, coding validation related to CDM issues (CPT / HCPCS code applications), compliance coding, appropriate billing, operational workflows and other processes which affect appropriate charge integrity.
  • Will assist with the following audits as well; RAC, Payer Defense Requests, Patient Complaint, OIG, C-suite requested audits, etc. The process will include a thorough review of the medical record and billing forms to verify services provided were accurately reported. Reports to Ardent, Director Charge Integrity.
  • Position will cover audit requests received or scheduled from all Ardent markets.

Qualifications:

  • Bachelor’s or Associate’s Degree in a Healthcare Discipline (LPN, RN, required) preferably with a coding certification from AHIMA (RHIT, CCS).
  • Prefer two (2) years consulting experience in charge capture and medical chart auditing.
  • Licensure Desired: AHIMA, RHIT, CCS Certificate
  • Prefer two (2) years consulting experience in charge capture and medical chart auditing. Education may be substituted for relevant experience in accordance to policy.
  • Experience as a nurse auditor reviewing medical records, claims data, etc for charge capture accuracy.
  • Completion of reports for documentation of issues in Word and Excel spreadsheet formats.
  • Conduct medical chart and process reviews for potential billing discrepancies to include but not limited to accurate
    documentation, CPT / HCPCS codes, Revenue Codes, Outpatient Code Editor, and Correct Coding Initiative guidelines.
  • Must have technical knowledge of correct coding principles of CPT / HCPCS and modifier selection.

    Knowledge/Skills/Abilities:
    Must have a thorough knowledge of hospital operations, hospital charge capturing functions, charging system, revenue generation, and Medicare regulatory environment. Must be detail oriented and work both independently and collaboratively with various administrative and clinical staff. Must be professional and comfortable working with a variety of department managers.

Why Lovelace

  DNV Accredited

  Named to Becker’s Hospital Review’s list of 100 Hospitals with Great Neurosurgery and Spine Programs

  Truven Health Analytics named Lovelace Health System among the top 20 percent of health systems in the country, and is the only health system recognized for this honor in New Mexico

  Named one of the 150 Great Places to Work in Healthcare by Becker’s Hospital Hospital Review


Department / Location

CHARGE CAPTURE
Lovelace Shared Services - Albuquerque, NM