Compliance Nurse Specialist (RN) Job at Bethesda Health, Creve Coeur, MO

eVpZVU1LSllOR3BpZlQvOGZtNXNoUW5HOVE9PQ==
  • Bethesda Health
  • Creve Coeur, MO

Job Description

Bethesda Brings out the Best in Talented, Caring People!

At Bethesda, more than 1,200 employees dedicate their careers to improving the lives of others.

As a team member at Bethesda, you'll enjoy great benefits such as: 403b, daily pay, bonuses, career advancement opportunities, and holiday pay.

Medical, dental, vision, prescription, and life insurance available for regular status full and part time employees.

This is a Part Time Hourly Position

Summary

Responsible for conducting audits of the medical billing documentation supporting claims billed to third parties, particularly Medicare and Medicaid. These audits determine whether services provided to residents and billed, are consistent with medical record documentation and in accordance with appropriate third-party billing regulations and/or standards. Findings are communicated to appropriate personnel. Emphasis will be placed on MDS auditing and best practices documentation. Conducts internal audits of medical documentation supporting claims billed to third parties and billing is done in accordance with appropriate third-party regulations/standards. Assists in education of clinicians and billing staff to support compliance with third party documentation and billing standards. Provides education to clinical staff in the proper use of EMR reports related to documentation in the MDS. Prepares written reports of the results of the audits and presents them to management and billing staff with recommended corrective actions. Responds to questions from nursing / billing staff regarding billing, coding and documentation. Works on joint projects with other internal compliance staff to resolve billing and documentation issues. Follows established policies and procedures, quality assurance, safety, environmental and infection control standards. Assists with periodic clinical reviews of long-term care communities in preparation for governmental or other accrediting body inspections. Assists with periodic review of Quality Measures and education of the interdisciplinary team. Monitors documentation patterns for accuracy of information through the use of reporting mechanisms within the electronic medical record software.

Job Qualifications

  • Registered nurse, bachelor degree preferred
  • Active RN license in Missouri and Illinois, or willing to obtain as soon as possible
  • Two years of Long-Term care experience, with at least one year as MDS Coordinator
  • Acute care highly desirable
  • Knowledge of Medicare and Medicaid required
  • Experience training/teaching adults preferred
  • Software skills in Word, Excel, Power Point or equivalent required
  • Basic knowledge of and experience utilizing a personal computer
  • Verbal and written communication skills
  • Excellent interpersonal and organizational skills
  • Manual dexterity, coordination and skillful use of hands for working with required equipment
  • Ability to receive and express detailed information through oral communication, visual acuity
  • Ability to read and understand written directions

Category: RN

Job Tags

Hourly pay, Daily paid, Holiday work, Full time, Part time,

Similar Jobs

Happy Home Lending

Mortgage Loan Originator Job at Happy Home Lending

 ...Description Job Description Salary: Commission Only We're Hiring Loan Officers! Join Our Growing Team! Are you a motivated and driven individual looking to advance your career in the mortgage industry or looking to get into the Mortgage Industry? What We... 

Confidential

Chief People Officer & Executive Vice-President, People & Talent Job at Confidential

 ...Chief People Officer & Executive Vice-President, People & Talent About the Company Prominent water & wastewater utility serving the local...  ...in all HR areas, including talent acquisition, management, learning and development, compensation, benefits, labor, compliance,... 

Tutor Intelligence

Robot Video Game Tester ($20/hour) Job at Tutor Intelligence

 ...to instruct robots on new tasks. We are looking for an in-person tester and operator in our Watertown office to:Instruct robots on...  ...machine learning algorithmsThis is a position similar to video game testing, with many of the same required skills. This position is... 

Cement Recruiter

Quarry Manager Job at Cement Recruiter

 ...The Quarry Manager coordinates efforts with management in the planning, organizing, and scheduling activities of the employees working in the mine and aggregate crushing operations to produce cost-effective aggregates, according to quality control specifications and mine... 

Healthcare Talent Support

Psychiatric Nurse Practitioner PMHNP Job at Healthcare Talent Support

 ...with workplaces that foster growth, innovation, and compassion. Our client is actively seeking an experienced Remote Psychiatric Nurse Practitioner (PMHNP) to support their busy outpatient facilities. Key Responsibilities: A PMHNP (Psychiatric...