Revenue Cycle Nurse Auditor

The Revenue Cycle Nurse Auditor provides guidance, support and oversight to OSF Revenue Cycle team by reviewing clinical documentation of patient care for the purpose of internal and external audits, inquiries & patient concerns. Works collaboratively with other facility team members, compliance officers and compliance auditors to respond to deficiencies, to strengthen internal processes and mitigate incidence of fraud, waste and abuse or other violations of government health care programs.

Total Rewards:

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Pay range for this position is $37.05 - $54.54/hour. Actual pay is based on years of licensure. This is a Salaried position.

Overview:

POSITION SUMMARY:

The Revenue Cycle Nurse Auditor provides guidance, support and oversight to OSF Revenue Cycle team by reviewing clinical documentation of patient care for the purpose of internal and external audits, inquiries & patient concerns. Responsible for examining medical records to ensure that patient bills are correct. Works collaboratively with other facility team members, compliance officers and compliance auditors to respond to deficiencies, to strengthen internal processes and mitigate incidence of fraud, waste and abuse or other violations of government health care programs. Works to ensure clinical concerns raised by patients are reviewed thoroughly and resolved appropriately.

 

This position allows for fully remote work near any OSF location. Will need to be in person at Ministry Headquarters in Peoria IL approximately 2 days a week for the first month of work for training. 

 

EPIC and previous auditing experience is strongly preferred. 

Qualifications:

REQUIRED QUALIFICATIONS:

Education:

• BSN

Experience:

• 2 years RN experience

Licensure/Certifications:

• Registered Nurse in current state

Other skills/knowledge:

• Strong communication skills are essential due to necessary interactions with other healthcare providers and patients
• Excellent computer skills, including Microsoft Office (Outlook, Word, Excel and PowerPoint) & proficiency in EMR functionality

 

PREFERRED QUALIFICATIONS:

Experience:

• Working knowledge of federal and state statutes and regulations governing the healthcare industry
• Solid analytical & clinical skills with the ability to assess entity and Ministry-wide impact
• Working knowledge of insurance claim processing and third-party reimbursement

Other skills/knowledge:

• Strong understanding of managed care fundamentals & denial resolution process for both hospital and billing claims
• Demonstrated ability to develop clear and informative reports of findings

 

OSF HealthCare is an Equal Opportunity Employer.