The Senior Clinical Nurse Auditor has a vital role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions, and interdependencies from the provision of patient care to payment for services rendered. The Senior Clinical Nurse Auditor leads clinical audits to support the organization's overall revenue integrity by implementing best practice charge capture processes to support the organization's financial performance and ensure compliance with federal and state regulatory requirements. Under limited supervision from the Manager, Revenue Integrity or other more senior Revenue Integrity leaders, the Senior Clinical Nurse Auditor is responsible for the facilitation of Revenue Integrity initiatives involving multiple clinical departments and practices focusing on revenue cycle integrity. The Senior Clinical Nurse Auditor applies a variety of continuous improvement and process improvement initiatives collaborating with individuals and teams from project conception to implementation of process improvement initiatives. Project work may include technical analyses or may require facilitation of a large multi-disciplinary group of administrators and/or medical personnel.
Education
Bachelor's Degree Accounting required or Bachelor's Degree Related Field of Study required
Licenses and Credentials
Registered Nurse [RN - State License] - Generic - HR Only preferred Certified Inpatient Coder [CIC] - American Academy of Professional Coders (AAPC) preferred Certified Professional Coder [CPC] - American Academy of Professional Coders (AAPC) preferred Certified Professional Coder-Hospital [CPC-H] - American Academy of Professional Coders (AAPC) preferred Certified Coding Specialist [CCS] - American Health Information Management Association (AHIMA) preferred Registered Health Information Technician [RHIT] - American Health Information Management Association (AHIMA) preferred
Experience
Auditing experience in the healthcare industry 3-5 years preferred or Auditing experience 3-5 years required
Knowledge, Skills and Abilities
- Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, well-developed analytic and organizational skills.
- Strong oral and written communication skills
- Strong complex problem solving, and critical thinking skills required.
- Strong knowledge of clinical care processes and documentation.
- Strong character, credibility, ethics, and integrity.
- Strong organizational and time management skills.
- Ability to perform and manage clinical charge audits by comparing medical record documentation to charges captured and identify opportunities for improved revenue capture and/or compliance with regulatory requirements.
- Ability to research coding and regulatory requirements required.
- Ability to interact and garner trust with various levels of staff in the organization, particularly management and senior leadership by providing practical, sound, accurate and timely support.
- Ability to review and interpret clinical data to determine whether the services are well supported in the documentation.
- Ability to interact with all levels of health care personnel and hospital/finance management.
- Ability to work independently in a role that requires flexibility in an environment that is deadline driven.
- Ability to research applicable CMS regulations, MGB charging policies and payer medical and reimbursement policies.
- Flexibility, innovation, and creativity are necessary characteristics of the successful candidate.
- Experience with computer software programs such as Microsoft Office Suite (PPT, Word, Excel, etc.) and Epic.
- Demonstrated success in building and maintain collaborative work relationships, internally, and externally, across a diverse set of organizations and/or functions.
- Adept at project planning / management, with the ability to effectively prioritize, delegate, and monitor.
- Individual is expected to continuously learn and apply new continuous improvement methodologies, and to spread successful innovation through the enterprise.
This is a part-time role, with 2 available schedules: - 3 days a week, 24 hours - 2 days a week, 16 hours The schedule must be between M-F, 8 AM-5 PM EST, and open availability to attend team meetings. This role is fully remote.
Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
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Mass General Brigham (Enterprise Services)
Aug 06, 2025