Revenue Integrity RN

at Rush University Medical Center in Chicago, Illinois, United States

Job Description

Job Description

Location: Chicago, IL

Hospital: RUSH University Medical Center

Department: Revenue Cycle Revenue Integrit

Work Type: Full Time (Total FTE between 0.9 and 1.0)

Shift: Shift 1

Work Schedule: 8 Hr (8:00:00 AM – 4:30:00 PM)

Summary:

The Revenue Integrity RN position will use collaboration, assessments, training skills, and clinical knowledge to ensure that patient charges are accurate. In a hybrid/remote setting, the Revenue Integrity Nurse RN reviews charges and clinical documentation, initiates and leads performance improvement efforts, and educates clinical departments about charging while promoting revenue integrity. This nurse exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Other information:

Required Job Qualifications:

- Current State of Illinois RN Licensure

- Associates or Bachelor’s degree in nursing

- Five years of clinical nursing experience using Epic software

- Mathematical skills related to pharmaceutical dose and unit calculations

- Understanding of clinical charging

- Demonstrated ability to communicate clearly and effectively

- Strong interpersonal skills necessary for the communication and training of Revenue Integrity concepts

- Ability to perform multiple tasks with excellent time management skills

- Proficient in Microsoft Office, Excel, PowerPoint, and Word skills

Preferred Job Qualifications:

- Experience with Epic work queues, CPT/HCPCS codes, UB-04 Revenue Codes, Modifiers, and NCCI edits

- Charge audit or finance-related experience

- AHIMA or AAPC Certification (CCS, CCA,, CPC, COC, CPMA, RHIT or RHIA)

- Procedural nursing including Operating room, Labor and Delivery, Cath lab, Interventional Radiology, or Emergency Room

Physical Demands:

Disclaimer: The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Responsibilities:

1. Connects the Clinical Operations knowledge and experience to the Revenue Integrity, charge description master (CDM), charge capture and metrics to ensure accurate revenue and reimbursement

2. Improves revenue results by optimizing and improving the clinical, operational, and revenue integrity processes related to patient charges

3. Builds relationships within the revenue cycle, and engage clinical areas of the organization that serve as mutually beneficial partnerships

4. Reviews CPT/HCPCS descriptions and charges with clinical documentation to ensure compliant charging

5. Identifies services performed in the clinical department for individual patients that need to be built in the Charge Description Master (CDM)or be charged on a patient’s account based on CPT/HCPCS descriptions compared to clinical activities. Adjusts charges on patient accounts as needed.

6. Identifies chargeable supplies, implants, devices, and pharmaceuticals

7. Identifies and trouble-shoots charging, CDM, or clinical documentation issues and works with ancillary departments to resolve

8. Provides recommendations on cost-containment related to charges, for clinical areas

9. Contributes to internal controls to ensure compliance with charging regulations

10. Serves as a clinical resource and subject matter resource (SME) for Revenue Cycle teammates

11. Works collaboratively with clinical staff, operations, ancillary departments, teammates, and vendors

12. Identifies patterns, trends, variances, and opportunities to improve charging accuracy

13. Engages clinical departments in revenue integrity; research code and charge questions as requested

14. Provides education to clinical departments to promote appropriate charge capture processes and documentation requirements for specific charge activity

15. Engages in development and growth in the Revenue Integrity Nurse specialty

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

Position Revenue Integrity RN

Location US:IL:Chicago

Req ID 11020