Career Opportunities

This service is available to employers and our members but is not an AAMAS endorsement of the employers or positions advertised. Positions are posted for 3 months at $200. If you wish to place an advertisement on this page please email your position description to lpocsik@resourcenter.com


Nurse Auditor
Health Systems International
Montgomery, Alabama


The Auditor will be responsible for performing billing and coding (must have minimum two years experience in billing/coding) audits to ensure charges are supported by appropriate clinical documentation, and comply with various states workers compensation fee schedules. The Auditor should possess excellent mathematical, organization, customer service, analytical/critical thinking and verbal communication skills.

Qualifications include current Certified Medical Audit Specialist credential or Certified Professional Coder Credential. Proficiency in various software packages, ability to work well under pressure and meet deadlines while managing multiple projects and ability to cultivate a team environment.

Send resume to jbetz@us-hsi.com


Posted July 12, 2012


RN CMAS Hospital Bill Auditor
(Independent Contractor Only)


Opportunity: On site and/or Off-site RN CMAS Hospital Bill Auditor (Independent Contractor Only).

URAC-accredited IRO based in Orange County, California is looking for independent contractor CMAS-certified RNs to do hospital bill line audits on site in Seattle, Portland, the San Francisco Bay Area, the Los Angeles/San Diego Area, Phoenix and Denver. Please contact and email resume to Jana Lopez CCP CMAS at jana@healthclaim.net. Thank you for your interest. (This ad does not constitute an offer for employment.)


Posted June 19, 2012


Senior Nurse Auditor
San Jacinto Methodist Hospital
Houston, TX


The Senior Nurse Auditor will be responsible for the comprehensive application of the hospital audit program, including the identification of revenue enhancement opportunities and compliance enforcement opportunities, chart auditing, the compilation and presentation of results, and the development and delivery of instructional information to facilitate efficient operations, expeditious reimbursement and compliance.

Responsibilities Include:

  • Assesses operational data and workflow to identify revenue enhancement opportunities and compliance issues relative to organizational goals and objectives
  • Develops and implements an adaptable Audit Program according to the opportunities identified
  • Ensures the timely and comprehensive auditing of accounts as dictated by the Audit Program, patient requests, and third party payer requests
  • Ensures timely and professional communication to the patient, payer or other party to facilitate dispute resolution
  • Ensures the comprehensive trending and compilation of audit data in an organized, professional format
  • Acts as chairperson of the monthly Audit Committee, to present audit results and to facilitate action planning for process improvement and implementation
  • Represents the Audit Committee as a member of the Hospital Compliance Committee to ensure the achievement of organizational goals
  • Develops and facilitates the ongoing departmental education program relative to audit findings
  • Maintains updated level of expertise by conducting appropriate research and attending seminars relative to issues regarding revenue generation and compliance

Qualifications Include:

  • RN education, with current Texas licensure
  • 8 years of nursing experience, 5 years of hospital experience and 2 years of experience as nurse auditor or case manager required.
  • Supervisory and Charge Master experience preferred
  • Certified Medical Audit Specialist, as mandated through the American Association of Medical Audit Specialists, preferred
  • Excellent mathematical, organizational, customer service, analytical/critical thinking and written and verbal communication skills
  • Proficiency in various software packages, such as Microsoft Office software
  • Ability to coordinate, prepare and present data in a professional manner
  • Ability to work well under pressure and meet deadlines while managing multiple projects
  • Ability to create and facilitate training and educational materials
  • Ability to provide productive coaching and cultivate a team environment

Qualified candidates, please apply online at: http://www.methodisthealthcareers.com/126

About San Jacinto Methodist Hospital

San Jacinto Methodist Hospital has been recognized by HealthGrades™ for our exceptional quality of patient care and has been named a Distinguished Hospital for Clinical Excellence™ for the 4th consecutive year. U.S. News & World Report has recognized us as one of “Houston Metro’s Best Hospitals” – San Jacinto was ranked 9th best out of 99 hospitals. San Jacinto Methodist Hospital is part of The Methodist Hospital System, a diverse, inclusive and growing health care organization with a history of health care innovation. We’ve once again been named to FORTUNE’s list of “100 Best Companies to Work For” – an accolade achieved annually since 2006.

Make your first day exceptional…at San Jacinto Methodist Hospital.

Our success as an organization is due to the diversity of our team. We are an equal opportunity employer.

Apply Here: http://www.Click2Apply.net/prqf9pd


Posted June 8, 2012


Work for us and let your voice be heard. Join a company that's actively working to transform the health care system. A place where employees are encouraged to speak up and share innovative ideas. A community that passionately rejects the status quo.

Payment Integrity Auditor
Portland, OR; Medford, OR; Salem, OR; Lewiston, ID; Burlington, WA; Tacoma, WA; Seattle, WA; Salt Lake City, UT; Telework


This position can be a telework position but must reside in WA, UT, ID, and OR.

Bring your knowledge of medical compliance audits to this role where you will assist in planning, coordinating, conducting, and reporting on post payment claims audits of the Payment Integrity Department, as well as special projects as requested by the Manager.

Key qualifications and experience:

  • 2 years audit experience, or the equivalent combination of education and job-related experience
  • Experience in correct coding audits, medical compliance audits or contract compliance is preferred
  • Skilled in the use of personal computer software, such as Microsoft Word, Excel, PowerPoint, and Lotus Notes
  • Ability to present ideas and recommendations, prepare clear, concise written narratives, memoranda, and reports; complete assignments with little supervision and within prescribed time frames
  • Bachelor's Degree in Business or related field

The Payment Integrity Auditor we seek will conduct sensitive investigations and maintain confidentiality of information, present ideas and recommendations.

Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. To search and apply for employment opportunities at Regence, visit us at www.cambiahealth.com/careers and apply to Job # 20045.

Hard work and dedication are rewarded at Cambia. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. Drug Screening and Background Check is required.


Posted June 8, 2012


Eisenhower Medical Center
Job Title: Nurse Auditor – Revenue Recognition
Rancho Mirage, California


Located in Southern California, Eisenhower Medical Center is a not-for-profit hospital seeking an experienced Nurse Auditor. Please visit Careers.EMC.org to learn more information and apply. 

The Nurse Auditor – Revenue Recognition must meet the following job requirements:

  • AA Degree in Nursing
  • RN License-State of CA
  • Experienced Medical Auditor knowledge of Medical Records and coding
  • Prior customer service preferred

Nurse Auditor – Revenue Recognition responsibilities include:

  • Responsible for concurrent audits of Medical Record Chart for verification of consistent demographic data and completeness of clinical documentation.
  • Responsible for pre-auditing medical records for all accounts scheduled for audits by insurance companies, external audit agencies and/or patient requested audits.
  • Responsible for instituting and leading Process Improvement Teams to record, quantify and correct deficiencies.
  • Represents Revenue Recognition department to share audit finding with existing Hospital Chart Audit Committee and Hospital Compliance Officer and Committee.

Eisenhower is proud to offer:

  • Competitive compensation
  • A generous benefits package and matched retirement plan
  • Health and wellness programs

About Eisenhower Medical Center:

Near Palm Springs, California, our vibrant community offers an enviable lifestyle including affordable housing, minimal traffic, world-class dining and shopping, and year round recreational activities. Additionally, Eisenhower Medical Center is less than two hours away from sandy beaches and mountain resorts.

At Eisenhower Medical Center, we offer a progressive environment with an emphasis on individual growth and advanced medical practices seldom seen in other hospitals. As a not-for-profit and comprehensive health care institution located in Southern California, we are the proud recipient of the 2009 Distinguished Hospital award for Excellence™ by HealthGrades® and the 2010 Gallup Great Workplace award.

Located on 130 acres in Rancho Mirage, we offer our community a 542-bed acute care hospital with telemetry, critical care and medical/surgical floors.  We also have a multitude of specialty centers including The Betty Ford Center, The Barbara Sinatra Children’s Center and The Annenberg Center for Health Sciences.

Eisenhower is renowned for its Centers of Excellence in Orthopedics, ranked #1 in California for Joint Replacement three years in a row (2008, 2009 & 2010) in HealthGrades®, as well as its Centers of Excellence in Cardiovascular, Neuroscience and Oncology. Additionally, Eisenhower was the first hospital in Riverside and San Bernardino counties to be designated a Certified Primary Stroke Center by The Joint Commission. Eisenhower fosters a respectful, supportive and friendly work environment.

Come JOIN our TEAM! To apply for a position now please visit Careers.EMC.org.


Posted June 6, 2012


Work for us and let your voice be heard. Join a company that's actively working to transform the health care system. A place where employees are encouraged to speak up and share innovative ideas. A community that passionately rejects the status quo.

Medicare Compliance Auditor, Regence Rx
Portland, OR


Bring your knowledge of auditing to this role where you will assist in planning, coordinating, conducting, and reporting on Medicare monitoring activities as well as compliance audits of corporate Medicare Advantage and Part D systems and processes, as well as special projects as requested by the Assistant Director of Medicare Compliance.

Key qualifications and experience:

  • 1+ year demonstrated experience in auditing, compliance or compliance-related activities, including conducting investigations , developing or using monitoring or auditing tools, developing and implementing monitoring or auditing work plans or monitoring or auditing for programmatic compliance
  • Must be proactive and operate independently to get work completed and goals achieved within set timeframes
  • Conduct research on regulatory requirements, understand complex regulatory requirements and incorporate them into auditing and monitoring tools
  • Highly developed analytical skills
  • Work effectively with many different groups both internally and externally to the organization
  • Law Degree, legal training, Medicare related training, or Master's Degree in Business Administration, Accounting, Public Health, or Healthcare Administration is preferred
  • Bachelor's Degree in Business Administration, Public Health, or Healthcare Administration or equivalent education and experience is required

Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. To search and apply for employment opportunities at Regence, visit us at www.cambiahealth.com/careers and Apply to Job # 19922

Hard work and dedication are rewarded at Cambia. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. Drug Screening and Background Check is required.


Posted May 8, 2012


Certified Medical Auditor
Available for Remote and On Site Audit Assignments


Contact Information:
Allen Shane, BSN, RN, CMAS, CCM, CLNC, LHRM
Cell - (863) 604-0767
Email - ashane2000@aol.com

Certified Medical Audit Specialist (CMAS)
Certified Legal Nurse Consultant (CLNC)
Independent Consultant

Experience:
Registered Nurse with 27 years  varied experience in clinical and management roles
7 years medical audit experience

Experienced with:

  • Medical billing audits
  • Medical record reviews and analysis of data
  • Hospital Financial Management - Billing audits, appeals, collections, charge management, liaison to clinical departments, patient billing dispute audits, risk management audits
  •  Independent Consultant - Auditor relief for hospitals, interviewing/training of new auditors, third party billing audits, financial system conversion audits, quality audits
  • Knowledge of CPT and ICD - 9 coding
  • Interaction with Chief Financial Officers, department directors,  revenue management  staff, payers, and clinical staff.

Professional Affiliations:
American Association of Medical Audit Specialists (AAMAS)
Program Committee Chair (2008 - Present)

Florida Medical Auditors Association (FMAA)
Past President
Board Member / CEU Coordinator

American Association of Legal Nurse Consultants
Greater Tampa Chapter
Member

Education:
Polk State College - Winter Haven, Florida
Associate Degree Nursing

Florida Southern College - Lakeland, Florida
Bachelor of Science in Nursing

University of Central Florida - Orlando, Florida
Health Care Risk Management Program

Vickie Milazzo Institute - Houston, Texas
Legal Nurse Consulting Certificate Program

Certifications:
Certified Medical Audit Specialist (CMAS)
Certified Legal Nurse Consultant (CLNC)
Certified Case Manager (CCM)
Licensed Florida Healthcare Risk Manager(LHRM)
Registered Nurse - Licensed in Florida 


Posted May 4, 2012


Manager, Clinical (RN) Audit Specialist
Newnan, Georgia


CANCER TREATMENT CENTERS OF AMERICA (CTCA)

Cancer Treatment Centers of America (CTCA) is a national network of regional, destination hospitals specializing in complex and advanced-stage cancer care. The CTCA model integrates state-of-the-art treatments and technologies with nutrition, naturopathic medicine, mind-body medicine, oncology rehabilitation and spiritual support. CTCA employs over 3,000 talented Stakeholders (employees) who create, deliver and continually improve the Mother Standard of Care based upon what cancer patients need and value. CTCA Stakeholders form the backbone of the CTCA experience; and their energy, and passion, creates a home of hope and healing to cancer patients across America.

CTCA is building a new hospital in Newnan, Georgia that will be a 212,000-square-foot, all digital facility focused exclusively on treating cancer. It will include 50 beds, ICU rooms, surgical suites, state-of-the-art radiation and infusion therapy departments, outpatient clinic rehabilitation and physical therapy department and onsite residential accommodations for outpatients and their families. We are currently seeking dedicated Stakeholders to help us fulfill our Mission and provide the Mother Standard of Care to patients in the Southeast.

OVERVIEW

The Manager, Clinical (RN) Audit Specialist will report to the Director of Compliance and will manage, plan and enforce the hospital bill audit program. This position is also responsible for developing, implementing and monitoring policies and procedures to ensure compliance with applicable laws, regulations, and standards including Medicare and Medicaid reimbursement. This position will coordinate the development of education and training programs relating to the hospital bill audit program and will assist in all phases of the Revenue Cycle to ensure accurate, compliant and timely billing, proper documentation, maximum reimbursement, and high patient satisfaction.

JOB RESPONSIBILITIES

Oversees and performs random focused and payer defense audits of patient accounts; Monitors assigned billing reports and processes accounts according to hospital policies and procedures and requests system reports that identify rejected, missing, invalid, etc. transactions that relate to the charge capture process.

  • Works closely with the Physician Billing Team to ensure a compliant and efficient billing process.
  • Performs analyses of the charge capture process for assigned departments and prepares reports documenting findings; identifies issues related to the charge capture process, communicates these issues to department management and assists appropriate personnel in the development of corrective action plans and charge forms.
  • Provides guidance and education to departmental personnel on charge entry and compliance issues. Also serves as an educational resource to all members of the revenue cycle team on an ongoing basis on issues related to charge capture and charge appropriateness.
  • Trains and leads audit staff in auditing procedures and reviews auditor work papers to ensure completeness and proper documentation of audit findings.

EDUCATION/EXPERIENCE

  • RN/LPN required; BA/BS in appropriate field preferred; HIM background and/or coding certification desirable.
  • RN Clinical Hospital background of at least two years required; Minimum one year of acute care charge master, coding or reimbursement experience (Medicare or other third party billing experience).
  • Knowledge of CPT/HCPCS/UB04 revenue coding, modifiers, Medicare APCs (Ambulatory Procedure Classifications) and billing regulations, DRGs, documentation standards, fee schedules, third party billing, & documentation standards required
  • Strong computer skills with knowledge of Microsoft Outlook, Word, Excel and hospital information systems required.
  • An overall knowledge of functions & activities of hospitals, understanding of compliance, knowledge of various payment systems, skill in researching and resolving problems and issues.

To apply for this opportunity, please email Nancy Dall at nancy.dall@ctca-hope.com.


Posted May 3, 2012