RN Clinical Audit Specialist - Rex ED Overhead

Job Description

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:
collaborates with departments to perform requested audits, documents additions and corrects errors, enters accurate patient billing, validates and updates all charges, and communicates department charging issues when necessary.

Responsibilities:
1. Promotes service excellence by serving as a role model and addressing patient/family concerns.
2. Maintains a thorough understanding of both Rex Healthcare and Emergency Services policies and procedures.
3. Validates and updates charges found in Chargemaster. Enters accurate patient billing information to the charge system. Reconciles Pyxis charges. Departmental charging issues are noted and communicated to the appropriate department head via monthly reports and verbally on an as-needed basis. Provide support to Billing, Patient Accounting and insurance representatives to assist with billing issues and patient inquiries. Keeps current with OIG and Medicare billing issues to assist in hospital compliance.
4. Assists in follow up of culture results of discharged patients.
5. Documents additions and corrects errors to charge sheet according to department standard.
6. Orients new staff to the charging practices and documentation standards of the department. Communicates with staff for needed documentation for accurate charging and billing.
7. Collaborates with appropriate departments when needed to perform requested audits.
8. Maintain an understanding of medical record practices, standards and regulations of Health/Care Finance Administration and Medical Review of North Carolina, etc.

Other Information

Other information:
Education Requirements:
● Graduate of an accredited school of nursing. At least two (2) years previous Emergency Department nursing experience.
Licensure/Certification Requirements:
● RN NC LIC
Professional Experience Requirements:
● At least two (2) years previous Emergency Department nursing experience. High level of interpersonal skills and organizational abilities. Ability to deal with difficult situations and fast paced environment. ED charging/coding experience preferred. High level of interpersonal skills and organizational abilities. Ability to deal with difficult situations and fast paced environment. ED charging/coding experience preferred.
Knowledge/Skills/and Abilities Requirements:
● Language Skills: Ability to read, analyze, and interpret clinical information and technical procedures. Ability to document clinical information. Ability to effectively communicate information and respond to questions from patients, physicians, family members, and other Rex staff. Mathematical Skills: Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Reasoning Ability: Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions.

Job Details

Legal Employer: NCHEALTH

Entity: UNC REX Healthcare

Organization Unit: Rex ED Overhead 

Work Type: Per Diem

Standard Hours Per Week: 4.00

Work Schedule: Day Job

Location of Job: US:NC:Raleigh

Exempt From Overtime: Exempt: No