SSM Health Hiring for RN-Clinical Auditor at Jefferson City, Missouri Full Time

Performs clinical audits within Revenue Cycle operations.

• Review medical record documentation and compare against medical bills, claims and revenue reports.

• Resolves inquiries from internal and external sources to reconcile accounts accurately and within compliance guidelines.

• Responsible for contacting various departments in multiple facilities to facilitate changes to improve revenue cycle.

• Ensures compliance with government and billing guidelines by reviewing and splitting or combining claims per clinical/billing guidelines.

• Enhances net revenue by splitting charges that should be presented on separate claims to capture entitled revenue.

• Increases accurate claim submission by reviewing, researching, resolving, and trending claim issues in a timely manner.

EDUCATION

• Graduate of an accredited school of nursing

EXPERIENCE

• One year registered nurse experience

SSM Health is committed to equal employment opportunity based on race, color, religion, national origin, gender, sexual orientation, gender identity, pregnancy, age, physical or mental disability, veteran status, and all other statuses protected by law.