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Nurse Auditor 2-RN Chart Auditor

Company: Humana
Location: Chattanooga
Posted on: January 17, 2020

Job Description:

DescriptionThe RN Chart Auditor performs clinical audit/validation processes to ensure that the hospital itemized bill and the medical record documentation for services rendered is complete, compliant and accurate to support optimal reimbursement. RN Chart Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.ResponsibilitiesThe RN Chart Auditor reviews and analyzes the hospital itemized bill, to identify charges not separately billable for inpatient stays and the medical records, and related hospital documentation, to validate the billed charges are supported by the records. Applies clinical experience when conducting reviews. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.Required Qualifications

  • Associates Degree in Nursing
  • Active Registered Nurse (RN) license
  • 3 or more years experience in hospital chart reviews/auditing for inpatient claims
  • 3 or more years clinical experience in a hospital setting
  • Must be able to demonstrate the ability to read a hospital medical chart and hospital IB
  • Demonstrated ability to lead process/project initiatives
  • MS Office proficiency
  • Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information
  • Ability to work independently and manage work load
  • Customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
  • Excellent writing, editing, interpersonal, planning, teamwork, and communications skills
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiencesPreferred Qualifications
    • CMAS, CMCA or equivalent chart auditing certification preferred
    • Bachelors Degree preferred
    • 5 plus years in hospital chart auditing
    • ICD10/CPT coding a plusAdditional InformationScheduled Weekly Hours40About UsMission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity EmployerIt is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.Humana Safety and SecurityHumana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailboxtasrecruit@humana.com to validate the request.

Keywords: Humana, Chattanooga , Nurse Auditor 2-RN Chart Auditor, Healthcare , Chattanooga, Tennessee

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