Nursing Coordinator Clinical Audits PT
Essential Job Accountabilities:
Job
Summary:
The Nursing Coordinator Clinical Audits performs detail analytical audit studies to verify accuracy of patient accounts.
Provides back up for the Emergency Room / Utilization Review Auditor as needed.
Conducts exit interviews with commercial audits and provides technical support to senior management, as well as, the training of various departments' personnel.
Is also responsible for daily transaction audit report and monitoring departmental posting of charges in an accurate and timely manner.
Communicates with directors of areas to resolve deficiencies.
Responsible for the daily late charge report.
Knowledge of all Medicare requirements, which includes APC's, in addition to working with Medicare HMO Auditors.
Provide CPT codes and develops new charge numbers to increase reimbursement.
Essential Duties and
Responsibilities:
Commercial audits:
pre-audit accounts requiring an audit to verify detailed bill.
Concurrent audits:
reviews daily charges for accuracy.
Performs required third party payer audits prior to billing.
Provides charge and procedure pricing upon request.
Acts as liaison to Patient Advocate program for patient accounting issues relating to charges.
Attends meeting and participates when appropriate.
Performs additional functions as required as they relate to Admitting/ Registration responsibilities.
Actively assists and supports departmental activities to ensure that operational and salary expenses are equal to or less than approved budget.
Understands the principles and concepts of Performance Improvement.
Looks for opportunities and solutions for process improvements and seeks to improve job skills.
Education, Experience,
Qualifications:
High School Diploma or GED required.
Minimum of 1 year of experience.
RN with a current Florida License.
Recommended Skills Auditing Billing Cpt Coding Clinical Works Medical Emergency Medicare Estimated Salary: $20 to $28 per hour based on qualifications.
Job
Summary:
The Nursing Coordinator Clinical Audits performs detail analytical audit studies to verify accuracy of patient accounts.
Provides back up for the Emergency Room / Utilization Review Auditor as needed.
Conducts exit interviews with commercial audits and provides technical support to senior management, as well as, the training of various departments' personnel.
Is also responsible for daily transaction audit report and monitoring departmental posting of charges in an accurate and timely manner.
Communicates with directors of areas to resolve deficiencies.
Responsible for the daily late charge report.
Knowledge of all Medicare requirements, which includes APC's, in addition to working with Medicare HMO Auditors.
Provide CPT codes and develops new charge numbers to increase reimbursement.
Essential Duties and
Responsibilities:
Commercial audits:
pre-audit accounts requiring an audit to verify detailed bill.
Concurrent audits:
reviews daily charges for accuracy.
Performs required third party payer audits prior to billing.
Provides charge and procedure pricing upon request.
Acts as liaison to Patient Advocate program for patient accounting issues relating to charges.
Attends meeting and participates when appropriate.
Performs additional functions as required as they relate to Admitting/ Registration responsibilities.
Actively assists and supports departmental activities to ensure that operational and salary expenses are equal to or less than approved budget.
Understands the principles and concepts of Performance Improvement.
Looks for opportunities and solutions for process improvements and seeks to improve job skills.
Education, Experience,
Qualifications:
High School Diploma or GED required.
Minimum of 1 year of experience.
RN with a current Florida License.
Recommended Skills Auditing Billing Cpt Coding Clinical Works Medical Emergency Medicare Estimated Salary: $20 to $28 per hour based on qualifications.
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