Location: Egg Harbor Twp, NJ | Position Status: Full Time | Position Shift:
The Director, Medical Audits is responsible for conducting process improvement assessments of revenue cycle operations in clinical areas with a focus on improving the accuracy and timeliness of charge capture. Assessments primarily consist of “chart-to-bill” audits, interviews with key stakeholders, direct observation of charge entry and reconciliation processes, and analysis of relevant charge data. Analyzes the assessment results and develops recommendations for process improvement.
This position will collaborate with the Finance Department and other clinical and operational areas to implement process improvement strategies. Measures and monitors compliance with regular review, interpretation and distribution of system reports. Designs new reports as needed to support charge capture metrics.
Performs follow-up and conducts education and training with lagging departments/clinical areas. Acts as the principal liaison between the Finance Department and clinical directors for charging. Functions as a resource to the Finance Department and clinical areas for charge capture, coding, documentation and reconciliation process subject matter. This job requires a high level of problem-solving. Must be able to work independently. Acts as a resource to the clinical departments. Computer skills are essential. Will need to use Word, Excel, PowerPoint and Visio at a minimum.
Education: Clinician (RN); bachelor’s degree.
License/Certification: Registered nurse or other licensed healthcare practitioner required. Coding certification preferred.
Experience: Five years of varied clinical experience as an RN or other clinical specialist. Bachelor’s degree in clinical program required. Master’s degree preferred. Working knowledge of coding rules required or willingness to obtain within 3 months of hire. Experience with billing and documentation systems preferred.
Demonstrates the competencies as established by the department and on the Assessment and Evaluation Tool for this position.
Potential for exposure to the hazards and risk of the hospital environment, including exposure to infectious disease, hazardous substances and potential injury. This position requires desk/computer work a majority of the time. Requires some walking and standing and occasional lifting up to 20 lbs.
This position reports to the Director of Patient Accounting and supervises the PFS Medical Audit Coordinator.
The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.
AtlantiCare is an equal opportunity employer that takes affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.
Whether you lead an active life or love leisure, you’ll enjoy working and living in the beach communities of New Jersey’s southeastern shore.
Benefits & Wellness
We believe that healthcare should be a rewarding career. That’s why we offer excellent compensation, exceptional health and wellness benefits, and internal resources and programs to support professional growth for our team members. Here, you’ll find everything you need to pursue your calling of caring for others, knowing that you’re working for an organization dedicated to your overall well-being.
Inclusion & Diversity
Diversity and inclusion are at the heart of what makes AtlantiCare a great organization. We recognize and celebrate individual differences as dimensions that enrich our workforce and allow us to be more creative, flexible and competitive. Our inclusive culture welcomes our employees to freely contribute their diverse ideas, background, talents and experiences to make this a place where everyone can be, and do, their best work together.
For many, the shore communities of southeastern New Jersey are vacation destinations, but for AtlantiCare employees, they’re home. Working at AtlantiCare allows you to experience shore life year-round. Here, you’ll find natural beauty, world-class entertainment, rich history, amazing arts, abundant outdoor recreation, shopping, sophisticated dining and plenty of family-friendly events all within communities you’ll love to call home.
The spirit of collaboration is alive and well at AtlantiCare. We empower our teams to be agents of change within our system. We encourage growth and support advancement. Our shared vision for advancing the health of the communities and people we serve guides us to do what’s right for each patient, our healthcare delivery system and the practice of medicine as a whole. We teach, grow and advance medicine together.