Nurse Auditor in San Diego, CA at Scripps Corporate Offices

Date Posted: 7/16/2019

Job Snapshot

Job Description

At Scripps Health, you will experience the pride, support and respect of an organization that has been repeatedly recognized as one of the nation’s Top 100 Places to Work.

You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you’re open to change, go ahead and unlock your potential.

Come support our Business Services Team in this vital position that maintains hospital contracts and re-imbursements. Join a small influential team that makes a true impact in the Scripps Experience.

As a Nurse Auditor, you will work with the Inpatient Revenue Manager. The Nurse Auditor performs audits of medical records against the itemized bill and also performs special audit requests. Coordinates and reports audit outcome regarding charge errors, percentage of savings or losses for Scripps facilities, data processing errors, and the performance of hospital charging system, documentation and justification within the medical record and itemized bill.

Additional skill set requirements are strong quantitative, analytical and organization skills. Proficient in chart review, clinical record information systems and coding methodologies. Ability to understand and interpret medical records, hospital bills, and the chargemaster. Ability to understand all ancillary department functions for each of the Scripps facilities.

Ability to utilize and understand computer technology. Ability to understand insurance terms, i.e. HMO, PPO, EOB, Stop Loss, etc. Ability to effectively negotiate with Insurance carrier representatives. Ability to communicate orally and in written form. Must be team oriented with strong interpersonal skills.

This is a Full Time, Salaried position located at our Rancho Bernardo/4S Ranch Scripps Business Service Office.

Job Requirements

Required Education/Experience/Specialized Skills:
  • Strong analytical and organization skills. Strong negotiation skills.
  • Proficient in chart review systems.
  • Ability to understand and interpret medical records, hospital bills, and the chargemaster.
  • Ability to understand all ancillary department functions for each of the Scripps facilities.
  • Ability to utilize and understand computer technology.
  • Ability to understand basic insurance terms and payment methodologies.
  • Ability to effectively negotiate with insurance carriers and customers
Preferred Education/Experience/Specialized Skills/Certification:
  • Graduate of an approved LVN or RN program.
  • Bachelor degree
  • Experience with PC's, word-processing, spreadsheet, graphics, and database software applications is desired.
  • Previous auditing experience preferred.
  • Epic working experience preferred.
Scripps Health is repeatedly named on the Fortune Magazine’s 100 Best Companies to work for, the only San Diego-based company and Becker’s Healthcare Top Hospitals. Scripps Health offers a robust Total Rewards Program designed to compensate and motivate you throughout your career. Scripps Health Total Rewards Program includes a broad range of plans and programs including market competitive pay and performance incentives, health and wellness benefits, financial wellness benefits, work-life resources, learning and development opportunities, and rewards and recognition. Unlock your potential with Scripps Health today.

Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.