ICU RN Auditor

Overview

Hybrid - Taguig | 5-10 Yrs Exp | Bachelor | Full-time

Job title: ICU RN Auditor

Work set-up: Hybrid in Taguig

Work shift: Mid-shift

We are seeking a detail-oriented and experienced ICU RN Auditor to review and assess medical records, coding accuracy, and documentation compliance in intensive care unit (ICU) settings. The ideal candidate will have a strong background in critical care nursing, medical auditing, and regulatory compliance to ensure adherence to healthcare standards and best practices.

• Conduct audits of ICU patient records to assess accuracy, completeness, and compliance with medical guidelines and policies.
• Evaluate documentation for proper coding, billing, and reimbursement alignment with healthcare regulations.
• Identify discrepancies, errors, and areas for improvement in ICU charting and clinical documentation.
• Collaborate with healthcare teams, physicians, and administrative staff to provide feedback and recommendations for documentation improvement.
• Ensure adherence to hospital policies, CMS guidelines, and other regulatory requirements.
• Prepare detailed audit reports, including findings, trends, and recommendations.
• Assist in developing training programs for ICU nurses and medical staff to improve documentation accuracy.
• Stay up to date with healthcare regulations, coding changes (ICD-10, CPT), and best practices in medical auditing.

• Minimum 5 years experience in Post Payment Claims Auditing or ICU RN Auditor and 5-10 years experience on ICU/CCU nursing experience
• Exposed to ICU experience such as local/international bedside/hospital setting
• Has the following experience in ICU: reading patient’s record, auditing, assessment, claims, appeals, denials
• Has the understanding of ICD 9/10, CPT/HCPCS coding, DRG guidelines, correct coding initiative, revenue codes, modifiers and APC reimbursement
• PHRN English Language Medical Insurance Processing Strong Work Ethic Outbound Call

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