Registered Nurse-Clinical Auditor Sr

Clinical Documentation & Coding Auditing:

• Demonstrates knowledge of basic audit skills and adheres to Internal Audit Standards and UPH Internal Audit policies and methodologies.
• Utilize system software to efficiently research, document and test areas of risk.
• Validate diagnosis and procedure codes assigned are adequately supported by documentation in the medical record.

Improvement:

• Researches and develops appropriate audit programs and testing procedures that address compliance with clinical documentation requirements, coding, billing and other regulatory issues.
• Assesses clinical documentation, coding and billing practices for compliance with regulations of federal and state agencies and third party payers.
• Works with management to improve UPH staff education, compliance and controls related to clinical documentation, coding, billing and other regulatory issues.