UHC-RN Charge Auditor-OR

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).

EXPERIENCE:

1. Three (3)years of experienceas RN

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor of Science in Nursing

2. CNOR certification or perioperative specialty certification

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an exhaustive list of all responsibilities and duties. Other duties may be assigned.

1. Maintains an accurate and timely flow of patient charges incurred in assigned surgical and procedural areas.
2. Reviews Epic patient charts to validate clinical documentation and ensure accurate capture of implants, supplies, medications, and procedural charges.
3. Completes daily audit routines, including working the OR work queue for financial services, to ensure appropriate codes and charges are reflected on claims.
4. Calculates procedural charges in accordance with hospital standards including OR room time and applicable room rates based on procedures performed.
5. Extracts and compiles charges for routine supplies, pharmacy items, implants, and specialty items used during procedures.
6. Validates documented supply and implant usage against clinical records to ensure alignment with charge capture.
7. Reviews and optimizes surgical preference cards to ensure supplies and implants reflect actual clinical practice.
8. Evaluates case supply needs to ensure appropriate documentation and availability of supplies during procedures.
9. Collaborates with Supply Chain and Materials Management to maintain accurate supply item numbers and chargeable inventory within system platforms.
10. Initiates new procedures or supply items within Workday and Epic systems with appropriate charge amounts and coding as directed.
11. Utilizes multiple Epic modules, including Cupid, OpTime, and system dashboards, to review documentation and validate charge accuracy.
12. Processes daily surgery and procedure records according to established materials management and financial workflows.
13. Demonstrates ability to follow computer downtime procedures to maintain documentation and charge continuity.
14. Provides education and guidance to perioperative staff regarding proper documentation of supplies, implants, medications, and procedures to support accurate charge capture.
15. Maintains active dialogue with clinical departments, materials management, and financial services to clarify charges and resolve discrepancies.
16. Communicates workflow barriers or operational issues affecting documentation or charging to leadership in a timely manner.
17. Maintains confidentiality in accordance with hospital policies when interacting with patients, physicians, families, and staff regarding clinical and financial information.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.Requires frequent standing, walking, bending, squatting, and stooping.
2. Requires sitting at a computer.
3. Requires verbal ability to communicate with patients and staff.
4. Requires corrective vision and hearing within normal range.
5. Requires ability to lift and carry items of various weights and sizes.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Clinical/OR environment

SKILLS AND ABILITIES:

1. Strong analytical, organizational, and communication skills

2. Ability to collaborate effectively with clinical staff, supply chain teams, and revenue cycle departments.