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Nurse Auditor, Revenue Integrity

Remote · South Africa Full-time

Job Description

  • Provides safe, quality health care services & / or assistance to patients under the supervision & direction of a registered nurse or other designated health care professional
  • Performs clinical care activities (direct or indirect) for patients within the “scope of practice” laws & training received
  • Cares for patients safely by assisting in clinical care services or engaging in administrative activities
  • Communicates effectively and respectfully
  • Performs work in a safe, engaging, & supportive manner
  • Maintains knowledge of applicable federal, state & local laws
  • Performs nursing interventions or clinical knowledge application in decision-making
  • May administer medication & carry out therapeutic treatment within scope of license
  • Advocates for patients & informs patients and families about care details
  • Collaborates with Revenue Integrity team on opportunities to improve & implement front-end process to support denial prevention Requirements
  • High school diploma or GED
  • Completion of an accredited program associated with license
  • License in the applicable state(s) of engagement
  • Valid driver’s license where required by assignment
  • 4+ years of nursing experience
  • Demonstrated knowledge of revenue cycle & denial management functions
  • Experience in case management & utilization management
  • Customer service background is required
  • Registered Nurse, preferred
  • Bachelor’s degree, preferred
  • 2+ years of charge audit, managed care or comparable patient payment processing experience preferred
  • AAPC, AHIMA, CHRI certification/membership strongly preferred.
  • Outpatient CDI experience preferred
  • Working knowledge of Electronic Health Records (EHR), preferred Benefits Apply To this Job

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