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MUHA NU18 - RN-HPA Nurse Auditor

Apply now Job no: A511610
Entity: Medical University Hospital Authority (Medical Center)
Department: Finance and Support Services - Patient Access Services and HIS
Sub Department: MUHA-9769000-Medical Records Coding & Incomplete
Work type: Full-Time
Employee Type: MUHA-Regular
Location: Charleston, SC-West Ashley
Categories: Coding, NURSING
Pay scale: MUHA- Grade 15


Entity/Organization:  MUHA (Medical University Hospital Authority/Medical Center)

Hours per week: 40

Scheduled Work Hours/Shift: Day

Fair Labor Standards Act Status: Salaried

Job Summary/Purpose: The RN-Nurse Auditor reports to the Manager of Hospital Coding. Under indirect supervision, the Nurse Auditor performs specialized administrative duties pertaining to hospital billing and reimbursement activities. This position audits medical bills charges, reviews denied charges, recommends appeals and/or facilitates the resolution of root causes. This role communicates audit findings and works closely with external parties to include governmental and other third party payers. The RN-Nurse Auditor serves as a clinical resource to Hospital Coding, Hospital Patient Accounting and Revenue Systems.      

Minimum Training and Education: Bachelor’s degree in nursing from an accredited school of nursing and three years of related nursing experience required.   Demonstrated knowledge of payer reimbursement for both governmental and managed care payers required. Excellent written and verbal communication skills necessary.  Demonstrated knowledge of payer reimbursement for both governmental and managed care payers.   

Required Licensure, Certifications, Registrations: Licensure a registered nurse by the South Carolina Board of Nursing or compact state required. Current Basic Life Support (BLS) required, either a certification from an American Heart Association (AHA) BLS for Healthcare Providers (or AHA recognized equivalent) or an American Red Cross CPR/AED for Professional Rescuer and Healthcare Provider.

Additional Duties and Responsibilities:

Physical Requirements: Ability to perform job functions while standing. (Continuous) Ability to perform job functions while sitting. (Continuous) Ability to perform job functions while walking. (Continuous) Ability to climb stairs. (Infrequent) Ability to work indoors. (Continuous) Ability to work outside in temperature extremes. (Infrequent) Ability to work from elevated areas. (Frequent) Ability to work in confined/cramped spaces. (Frequent) Ability to perform job functions from kneeling positions. (Infrequent) Ability to bend at the waist. (Continuous) Ability to twist at the waist. (Frequent) Ability to squat and perform job functions. (Frequent) Ability to perform “pinching” operations. (Frequent) Ability to perform gross motor activities with fingers and hands. (Continuous) Ability to perform firm grasping with fingers and hands. (Continuous) Ability to perform fine manipulation with fingers and hands. (Continuous) Ability to reach overhead. (Frequent) Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Continuous) Ability to fully use both legs. (Continuous) Ability to use lower extremities for balance and coordination. (Frequent) Ability to reach in all directions. (Continuous) Ability to lift and carry 50 lbs. unassisted. (Infrequent) Ability to lift/lower objects 50 lbs. from/to floor from/to 36 inches unassisted. (Infrequent) Ability to lift from 36" to overhead 25 lbs. (Infrequent) Ability to exert up to 50 lbs. of force. (Frequent) Examples include: To transfer a 100 lb. patient that can not assist in the transfer requires 50 lbs. of force. For every 100 additional pounds, assistance will be required from another healthcare worker. 20 lbs. of force is needed to push a 400 lb. patient in a wheelchair on carpet. 25 lbs. of force is required to push a stretcher with a patient with one hand. Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous) Ability to see and recognize objects close at hand or at a distance. (Continuous) Ability to match or discriminate between colors. (Continuous) Ability to determine distance/relationship between objects; depth perception. (Continuous) Good peripheral vision capabilities. (Continuous) Ability to maintain hearing acuity, with correction. (Continuous) Ability to perform gross motor functions with frequent fine motor movements. (Continuous) Ability to deal effectively with stressful situations. (Continuous) Ability to work rotating shifts. (Frequent) Ability to work overtime as required. (Frequent) Ability to work in a latex safe environment. (Continuous) Ability to maintain tactile sensory functions. (Continuous) (Selected Positions) *Ability to maintain good olfactory sensory function. (Continuous) *(Selected Positions) *Ability to be qualified physically for respirator use, initially and as required. (Continuous) (Selected Positions)

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.


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Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.