nThrive

Nurse Auditor RN

Job ID
2017-20089
Employment Type
full-time
Metairie
Hours Per Week
0.00
LA

Overview

At nThrive, we are focused on empowering health care for every one in every community. The Nurse Auditor is responsible for auditing accounts for patients, billers, and other Departments of the hospital as needed.  

Responsibilities

  • Utilizes assigned work queues in the billing system, COMPAS and Charge Audit Tool to perform pending audits and assists Reimbursement RID Services with administrative duties.  
  • Reviews accounts, comparing claims to documentation contained in the medical record, assessing the accuracy of the claim and evaluating the effectiveness of the charging systems throughout the hospital. 
  • Validates and documents needed debits, credits, adjustments needed on claims, and making recommendations to the Director of Reimbursement and appropriate team members for improvements in process. 
  • Monitors statistical data based on audit results and effectively shares findings with ancillary departments to correct charge inequities.
  • Reviews daily reports to provide accurate billing data. 
  • Supports clinical staff in educational needs as it pertains to changes in charging practices related to Centers for Medicare & Medicaid Services (CMS) & Fiscal Intermediary (FI) updates. 
  • Provides Plastic Package Price estimates to physicians’ offices upon request.
  • Represents Reimbursement / RID Team on assigned committees to share trends and charging issues

Qualifications

  • RN with 3-5 years of clinical experience and at least 2 years of auditing experience. 
  • Familiarity with coding claims review, medical records review, and Charge Description Master (CDM) is essential. 
  • Must have a working knowledge of Word and Excel. 
  • Strong financial background desirable.
  • Credentialing:  Must provide current Year State of Louisiana RN license upon hire.

Preferred Skills

  • Strong communication and organizational skills, logical decision-making and analytical skills are essential. 
  • Effective interaction with team members and outside payers desirable. 
  • Familiarity with medical terminology and excellent verbal communication skills also desirable.

About nThrive

nThrive is the leader in providing end-to-end revenue cycle services, technology and education solutions. Previously known as MedAssets, Precyse, Equation and Adreima, each formerly a leader in its own right, we’ve combined our talents and capabilities into a single enterprise. At nThrive, we are people who are passionate about empowering health care for every one in every community. We work together to transform financial and operational performance, enabling health care organizations to thrive.
 
nThrive is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

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