Revenue Auditor

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

OCCUPATIONAL SUMMARY

Coordinates and finalizes patient account audits, prescreens patient medical records to recoup underbillings, and instructs and consults with hospital management and staff to resolve documentation inadequacies or make improvements in patient chart documentation and charging procedures. The duties of this position require the exercise of courtesy, patience, and discretion in speaking with patients, staff, and insurance companies in order to maintain sound public relations.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Coordinates the location and retrieval of patient medical records, reviews medical record for accuracy and completeness, and ensures availability of medical record for hospital preaudit and insurance company audits. Verifies the release of information authorization(s) to conduct audit.
2. Reviews patients medical record, identifies and analyzes diagnoses, procedures, and supplies pertaining to patient's hospital stay, and verifies that appropriate charges are listed on patient's itemized statement. Makes adjustments as necessary using knowledge of nursing procedures and practices.
3. Coordinates and analyzes data from multiple computer systems, and assimilates information from various data sources. Reports findings.
4. Coordinates the retrieval and distribution of itemized statements and pharmacy profiles on each patient account. Analyzes, summarizes, and organizes pharmacy profile to prepare for patient account audit by identifying and calculating the mixing and distribution of medications and IV solutions.
5. Researches late charges, credits, and payments to patient accounts, and acts as liaison between insurance companies and the Business Office for prepayments of charges.
6. Conducts inservice training with staff in patient care and ancillary departments in order to point out recurring documentation inadequacies and to suggest corrective measures.
7. Assists in the design of new forms for improved medical record documentation, and offers guidance in the creation of more efficient charging methods. Acts as a consultant to department managers to identify areas in which additional revenue could be realized.
8. Maintains and documents all Audit policies and procedures as they are created/updated.
9. Maintains the Hopsital's Observation log on an ongoing basis.
10. Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Immediately reports any mechanical or electrical equipment malfunctions, unsafe conditions, or employee/patient/visitor injuryaccident to Manager.

REQUIRED:

1. Graduate of an accredited school of nursing with Three (3) years experience in nursing care and medication administration or Licensed Practical Nurse with eight (8) years experience in nursing care and medication administration.
2. Demonstrated communication, mathematical, and analytical skills, and an ability to work independently and deal effectively with various types of personnel.
3. Demonstrated knowledge of computers, and computer spreadsheet and database financial programs.

PREFERRED:

1. Four (4) years experience as a Registered Nurse, plus one (1) year experience in auditing activities, and a demonstrated knowledge of Business Office or billing procedures.
2. One (1) year Critical Care and Neonatal Nursing experience.