Director- Nurse Auditing in Altamonte Springs, FL at Adventist Health System

Date Posted: 10/1/2018

Job Snapshot

  • Job Schedule
    Full-Time
  • Job Category
  • Date Posted:
    10/1/2018
  • Job ID:
    18012319
  • Job Function
    Patient Financial Services
  • Travel
    No
  • Shift
    1 - Day
  • AHS Zone
    1-Shared Services
  • Organization
    Adventist Health System Corporate Office

Job Description


Description

Work Hours/Shift

Full Time, Monday-Friday

Adventist Health System Corporate Office

Be part of the Adventist Health System family.

Where you work matters. Working here is like being part of a family. Not just with those you serve, but also with your team members. It’s about making a difference, saving lives, and helping others live a fuller one. You’ll be joining a family of tens of thousands of team members who understand that what they do is bigger than healthcare. It is living out our mission to Extend the Healing Ministry of Christ and being there for someone every step of the way-body, mind, and spirit.

This is more than a career. It is a calling.

With hospitals and facilities in 9 states, you’ll have endless opportunities to take your talents, develop your skills, and grow as a professional in a place that truly cares about your success. If you are driven, compassionate, someone who always wants to go above and beyond because you care and believe what you do makes a differenceAdventist Health System is for you.

GENERAL SUMMARY:

This position is responsible for independently collaborating with the AHS Revenue Cycle and AHSIS teams in the design, development, maintenance and testing of the charge integrity tool integrated within the Cerner platform.  This position assists with the installation and training of all the Nurse, Emergency and Surgery auditors.  This position also strives to integrate clinical operational knowledge with coding, billing and revenue management processes in order to optimize revenue capture within AHS clinical departments.  This includes educating and assisting clinical departments as well as ancillary service areas with process flows that embed best practices into charge/revenue capture.      


Qualifications
What you will be responsible for:
  • Independently audits patient's records for accuracy of charging.
  • Utilizes audits to focus on key issues in the revenue cycle for improvement.
  • Problem solves and recommends appropriate process flows to maintain billing and clinical compliance as regulatory bodies/ authoratative sources publish updated or new rules, regulations and guidance.
  • Routinely identifies charge capture opportunities and makes recommendations to department leadership on how they can improve the accuracy of charge capture processes, including preparing and sharing work flow documentation.
  • Is familiar with all revenue cycle functions and how they are impacted by the charge correction tool and revenue integrity processes and procedures.
  • Maintains the Nurse Auditor scorecard, and makes changes as needed to reflect the most pertinent KPI’s.
  • Reviews and approves change requests related to the charge correction tool and coordinates with AHS IS to implement approved changes.
  • As needed, communicates changes to nurse audit workflows to ensure they reflect current priorities and support best practice in nurse auditing.
  • Remains abreast of new regulatory requirements and reimbursement changes at the State and Federal level, and adjusts charging practices and system rules to address these changes.
  • Acts as liaison between clinical and revenue management departments, fostering a positive relationship between these areas to effectively address issues and challenges as they arise.
  • Proactively monitors the status of the charge correction tool to ensure the system is working as designed, and quickly addresses issues when outliers are identified.
  • Assists in the installation and maintenance of the charge correction tool, including preparing facilities to effectively use the tool and minimize billing delays
  • Consistently communicates with nurse audit leaders across AHS, keeping them abreast of Corporate PFS related activities, policy/procedure changes, system and software changes. Etc.
  • Works effectively with the Corporate PFS Training and Education team to produce timely and meaningful training materials related to the charge correction tool and the clinically driven revenue cycle.
  • Trouble-shoots nurse-audit related problems for member hospitals, always responding in a timely fashion and including other subject matter experts as needed to address these issues in a timely and accurate manner.
  •  Performs other duties as assigned by Executive Director of Patient Financial Services and the Vice President of Revenue Management.
 
What you will need:
  • R.N. License required
  • Minimum 3 years’ experience in hospital nurse auditing or related field
  • Strong computer skills, including competency in the core Microsoft Office applications
  • Ability to quickly learn new hardware and software applications, including legacy/core patient accounting systems.
  • Demonstrated ability to be self-directed  and to work with minimal supervision/oversight


This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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