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HOME CARE-NURSE AUDITOR

251490

Quality Department 125106

Active Full Time

Days


Indiana University Health is Indiana's most comprehensive health system, with 16 hospitals and more than 34,000 team members serving Hoosiers across the state. We're looking for team members who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day.

The position exists to manage compliance audits of clinical documentation. The incumbent is also responsible for conducting regular internal compliance audits of billed charge accuracy when requested by the organization Home Care.

QUALIFICATIONS/KNOWLEDGE/SKILLS/ABILITIES

  • Requires ability to supervise.
  • Requires current state of Indiana LPN or RN licensure.
  • Requires home care experience; broad clinical experience; background in surgery; utilization review; quality assurance/performance improvement preferred.
  • Requires experience with review and/or auditing of medical records.
  • Prefer experience with Medicare and/or Medicaid regulatory compliance programs.
  • Requires knowledge of home care Prospective Payment System; prior authorizations and home care billing.
  • Requires excellent written and verbal communication skills with the ability to effectively interact with all levels of internal and external customers.
  • Requires computer literacy utilizing various software applications.
  • Requires working knowledge of ICD-9; CPT-4 and HCPCS coding and UB-9 Requires ability to take initiative and meet objectives.
  • Requires organizational and problem solving skills.
  • Requires attention to detail.
  • Prefer COS-C and/or ASQ certification.


Apply teamwork. Apply experience. Apply skill. Apply yourself. And together we can change everything.

Indiana University Health has more than 34,000 team members, including more than 3,600 physicians and 1,200 advanced practice providers, and we're home to the largest nursing network in Indiana with more than 9,000 nursing team members at over 800 sites of care.

Indiana University Health is Indiana's most comprehensive healthcare system with hospitals and specialties ranked among the nation's best by U.S. News & World Report.

A unique partnership with the Indiana University School of Medicine one of the nation's largest medical schools gives patients access to groundbreaking research and innovative treatments, and it offers team members access to the latest science and the very best training advancing healthcare for all.

At IU Health, your personal and professional growth is a top priority. You will have access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.

With 16 hospitals, including eight with Magnet designation and five with Pathways to Excellence designation, our team members are leading the way through excellence.

IU Health is invested in the lives of Hoosiers, leading the transformation of healthcare to make Indiana one of the nation's healthiest states.