Description

Join us as a Nurse Auditor/Revenue Integrity/Charge Description Master (CDM) Analyst. In this role, you will perform essential audits of itemized charges against patient medical records and hospital documentation. Your expertise will help ensure accurate billing practices and improve healthcare outcomes.

Company Culture and Environment

We pride ourselves on fostering a supportive environment that encourages career growth and professional development. Our team values collaboration, effective communication, and a commitment to excellence in healthcare.

Career Growth and Development Opportunities

This role offers numerous opportunities for career advancement within a dynamic healthcare setting. You will receive additional resume support, pre-interview coaching, and have access to ongoing training resources to enhance your skills.

Detailed Benefits and Perks

In addition to standard benefits, we offer:

• Employee Assistance Program (EAP)
• Transportation benefits
• Paid Time Off (PTO), vacation, or sick leave

Compensation and Benefits

Enjoy a competitive pay range of \(40.00–\)42.00 per hour and eligibility for benefits based on your employment classification and tenure, including:

• Medical, dental, and vision insurance
• 401(k) with pre-tax and Roth contributions
• Short-term and long-term disability insurance
• Voluntary Life Insurance and AD&D coverage for you and your dependents
• Health Spending Account (HSA)
• Critical Illness, Accident, and Hospital plans

Why you should apply for this position today

If you are passionate about using your skills to improve healthcare billing accuracy and patient outcomes, this is your opportunity to make a difference. We encourage you to apply today and become a vital part of our mission.

Skills

• Medical Coding Proficiency: Familiarity with ICD-10-CM, CPT-4/HCPCS classification systems, and EMR systems.
• Nursing Background: Experience as an RN or LPN with charge entry or nurse auditing experience.
• Attention to Detail: Ability to sequence diagnoses and procedures accurately.
• Problem Solving: Knowledge of EOB, coding denials, and hospital coding processes.
• Certifications: Current CPC or equivalent certification required.

Responsibilities

• Conduct audits of itemized charges against patient medical records and hospital documentation.
• Assign modifiers to claims and advise billing staff on HCPCS codes and modifiers.
• Research claim edits for medical necessity and provide recommendations to the billing team.
• Collaborate with revenue-generating departments on lost charges, billing questions, proper coding, and education.
• Review documentation for observation accounts, ED visits, and injection/infusion charges.
• Prepare written audit reports for finance and claims departments, including recommendations for recovery.
• Educate various teams (e.g., claims, finance, and provider services) based on audit outcomes.
• Analyze trends to provide process improvement recommendations to hospital departments and committees.
• Communicate effectively in both written and verbal formats with clinical and non-clinical staff, as well as patients questioning their bills.

Qualifications

• At least 5 years of hospital coding experience.
• RN or LPN credentials (nursing background with charge entry experience is preferred).
• Nurse auditing experience is a strong plus.

Education Requirements

• Current CPC or equivalent certification required.

Education Requirements Credential Category

• Nursing (RN or LPN credentials).

Experience Requirements

• Minimum of 5 years of relevant experience in hospital coding and charge auditing.

Why work in Chesapeake, VA

Chesapeake offers a perfect blend of urban living and natural beauty, providing a supportive community for both personal and professional growth. The area boasts a low cost of living, excellent schools, and ample outdoor recreational opportunities, making it an ideal place to build a fulfilling career and enjoy a balanced lifestyle.