Hospital Audit Opportunities

ExecuHealth, Inc. - is based in Alpharetta, GA and focuses exclusively in the Healthcare Industry on a National Level.  Come see our site and learn more about who we are and how we can help you! (www.Execuhealth.com)

 

Our client, a not-for-profit healthcare network located in north metro Atlanta, includes 3 hospitals plus additional supporting medical facilities has the following openings:

 

Charge Audit Nurse -

The Charge Audit Nurse is part of a team whose primary responsibility is to improve the overall quality, compliance, and completeness of charges captured on each patient encounter.  This nurse performs detailed concurrent audits of complex patient accounts by comparing the medical records documentation to the charges.  This position also performs special audit activities, including defense audits and patient request audits.  This position will serve as an educational resource to all members of the revenue cycle team on an ongoing basis on issues related to charge capture and charge appropriateness.  The Charge Audit Nurse works closely with other Revenue Management Advisory Services staff and Hospital System Service Line management staff to provide accurate, critical information for identification of areas needing immediate attention to expedite compliance, recommend revenue cycle process improvements, and collect every dollar owed.

Minimum Qualifications:

-  Current licensure in Georgia for Registered Nurse. BSN required.

-  Highly developed communication skills and strong clinical decision-making ability required.

-  Knowledge of payor issues including documentation requirements and reimbursement policies preferred.

-  Five (5) years minimum recent experience in the healthcare industry required.

-  Working knowledge of healthcare revenue cycle functions, including coding and billing guidelines, government payor regulations required.  Must have revenue code and CPT coding knowledge.

 

Compliance Auditor/Coder

MINIMUM QUALIFICATIONS:
Associates Degree
RHIT and/or CCS certifications preferred
Knowledgeable regarding official coding guidelines, medical terminology, inpatient and outpatient coding, report preparation, data analysis and proficiency in Microsoft Office applications (Excel, Word and PowerPoint).
3 to 5 years of coding and auditing experience.

DUTIES / RESPONSIBILITIES:
Perform coding reviews for accuracy of CPT and ICD-9 codes, proper DRG assignment and documentation in support of all codes assigned.
Summarize findings and prepare reports for management on findings from coding audits.