Registered Nurse Auditor Operating Room at AdventHealth

Date Posted: 7/11/2019

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Tampa, FL
  • Job Category
  • Date Posted:
    7/11/2019
  • Job ID:
    19010373
  • Job Family
    Quality/Clinical Effectiveness
  • Travel
    Yes, 25 % of the Time
  • Shift
    1 - Day
  • Application Zone
    1-Shared Services
  • Organization
    AdventHealth Tampa

Job Description


Description

"Registered Nurse Auditor Operating Room" AdventHealth Tampa
Location Address: 3100 East Fletcher Avenue Tampa, Florida 33613
Top Reasons to Work at AdventHealth Tampa
  • Florida Hospital Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research.
  • Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery
  • Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come
  • Awarded the Get With The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.
 
Work Hours/Shift:
Full Time Days
 
You Will Be Responsible For:
  • Assist FH/Managed Care Department when outside agencies conduct audits involving hospital billing.
  • Work closely with FH/Managed Care department when outside agencies request chart audits.
  • When customer service complaints related to charges are received conducts research into the legitimacy of the charge
  • Logs price and billing complaints and reports results to supervisor.
  • Works closely with PFS/HIM/Finance to research and correct specific problem accounts or areas.

Qualifications

What will you need?

  • Ability to interact with the Hospital Financial Department, HIM personnel, and departmental leaders.
  • Knowledge of the disease process and treatment methodology is required and utilized at least 50% of the time.
  • Knowledge of ICD-9 and CPT Coding Principles as well as billing methodologies. Knowledge of computer system includes Windows, Excel, Cerner Clinical and Series billing systems. Ability to communicate effectively in writing and verbally. Must have financial analysis capabilities.
  • Occasional contact with patients and outsiders. Regular contact with employees.
  • The Nurse Auditor has access to institutional financial goals and ongoing reports supporting the achievement and benchmarks of the Finance Committee. The Nurse Auditor utilizes those goals to create reports from both Medical Records and financial systems. The Nurse Auditor has the responsibility to adhere to the Florida Hospital Corporate Compliance plan, to the rules and regulations of all local, state, and Federal agencies, and to the standards of all accrediting bodies.
  • Must be able to cover in absence of a Clinical Auditor
  • Must be adaptable and flexible as required
  • Regional Travel up to 20% required
  • RN with current Florida license
  • 3 years clinical hospital experience, CDM management, case management or order entry maintenance experience.
  • Knowledge of the disease process and treatment methodology is required and utilized at least 50% of the time.
  • BSN (preferred)
  • 3 years of auditing experience either for hospitals or insurance companies preferred.
  • RN
Job Summary:
The Nurse Auditor will ensure that the charges that are generated in the Cerner Clinical system are being properly billed. This will be accomplished by conducting chart audits that compare charges with physician orders, clinical documentation and reports. The Nurse Auditor will work closely with Financial Services and the Patient Accounting departments to review and correct any charge errors that they find. Complex charge issues that require research may be referred to this position by HIM, PFS, Customer Service or case management. The Nurse Auditor will work closely with the FH/Managed Care department anytime there are audits requested by an insurance company. This position will be responsible for participating in and occasionally chair meetings that address process improvement initiatives related to charge accuracy levels. Responsible for auditing multiple operational areas. Provides regional coverage as required to Tampa, Helen Ellis, Carrollwood, LTAC, Dade City, Ocala and Wesley Chapel.


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

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