Senior Nurse Clinical Auditor Days FT
Company: DMC Children's Hospital of Michigan
Location: Detroit
Posted on: April 25, 2024
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Job Description:
$10,000 Signing Bonus with relevant experience
Children's Hospital of Michigan is an international leader in
pediatric and adolescent medicine. Surgical services include
general, thoracic, reconstructive and cardiovascular. Imaging
technology designed specifically for children provides advanced
diagnostic services including Positron Emission Tomography (PET)
and MRI. The Children's Hospital of Michigan Emergency Department
is a verified Level 1 Pediatric Trauma Center and dedicated
pediatric burn center. Experts in pediatric critical care,
rehabilitation, and neonatal and perinatal medicine provide care
for thousands of children every year at Children's Hospital of
Michigan, Children's Hospital of Michigan - Troy and six ambulatory
sites.
Job Summary
Under limited direction and according to established policies and
procedures conducts audits of hospital bills and medical
records.
Ensures documented charges are correctly billed and billed charges
are documented in the medical record. Corrects billing errors in
the Patient Accounting system and in some cases, the Cerner
system.
Identifies, reports and recommends actions to improve charge
capture processes. Identifies new services and technology in the
clinical setting and facilitates establishment of new charges.
Conducts in-service training for hospital personnel to ensure
understanding of the importance of effective charge capture and
documentation of services performed.
Conducts complex reviews of departmental processes which include
registration, clinical activities, documentation and charge
capture. Identifies opportunities to maximize billing in accordance
with federal and state regulations.
Safeguards the assets of the DMC, advocates appropriate levels of
internal control and promotes operating effectiveness and
efficiency.
Defend the hospitals revenue through research, documentation and
negotiation by participating in and acting as a content expert for
the hospital in audits conducted by third parties including, but
not limited to, Blue Cross Catastrophic audits; HOPP audits; MPRO
audits and all commercial insurance audits.
Provides both clinical and technical/billing expertise and acts as
liaison and resource for user departments.
Analyzes results, identifies trends and patterns and prepares
monthly statistical and narrative reports for various levels of
hospital and corporate management.
Qualifications:
1.Bachelors Degree in Nursing.
2. Licensed Registered Nurse in the State of Michigan.
3. Three years of patient care experience in a hospital as a
Registered Nurse, at least one of which should be in a critical
patient care specialty area such as I.C.U., E.R. or O.R.
4. Charge audit or similar experience preferred.
5.One year experience as a Clinical Auditor.
Job:
Compliance
Primary Location:
Detroit, Michigan
Facility:
DMC Children's Hospital of Michigan
Job Type:
Full Time
Shift Type:
Days
Shift Begin:
8:00 AM
Shift End:
5:00 PM
2305002165Employment practices will not be influenced or affected
by an applicant's or employee's race, color, religion, sex
(including pregnancy), national origin, age, disability, genetic
information, sexual orientation, gender identity or expression,
veteran status or any other legally protected status. Tenet will
make reasonable accommodations for qualified individuals with
disabilities unless doing so would result in an undue
hardship.
Keywords: DMC Children's Hospital of Michigan, Detroit , Senior Nurse Clinical Auditor Days FT, Healthcare , Detroit, Michigan
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