St. Vincent Medical Center - CA Registered Nurse Auditor in United States

  • POSITION PURPOSE

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  • A clinically competent, registered, professional nurse who delivers care to acutely ill adolescent, adult and geriatric patients by utilizing the nursing process while maintaining standards of professional nursing. Assumes responsibility for nursing care and patient safety while in the Emergency Department. The RN also reviews medical records for accuracy of payment through verification of coding and billing as determined by clinical information and appropriate guidelines.

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  • EDUCATION/LICENSURE/CERTIFICATION

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  • ?         Los Angeles City Fire/Safety Card within 30 days of hire.

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  • ?         Current California registered nurse licensure.

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  • ?         Current American Heart Associate BLS certification

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  • ?         Current American Heart Associate ACLS certification

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  • ?         Current American Heart Associate PALS certification

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  • ?         Management of Assaultive Behavior certification

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  • MINIMUM EXPERIENCE REQUIRED

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  • ?         One year recent experience in Emergency Department.**

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  • ?         Registered Nurse with strong UM background preferred and active licensure in state of practice required.

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  • ?         BSN preferred.

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  • ?         Minimum seven years acute hospital care and/or utilization management experience preferred.

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  • ?         Strong knowledge of medical coding (CPT, ICD-10, HCPS) and reimbursement guidelines preferred.

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  • ?         Direct experience in medical chart review for inpatient providers preferred.

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  • ?         Experience in Medicare and commercial insurance environment preferred.

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  • ?         Knowledge of HIPAA laws and requirements preferred.

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