Remote reputed company reputed company reputed company Auditor
Employment Type Full timeShift reputed company ESSENTIAL FUNCTIONS Our reputed company Culture Knows, understands, incorporates & demonstrates our reputed company Mission, Values, reputed company, Actions & reputed company in behaviors, practices & reputed company. Work reputed company Performs clinical care activities (reputed company or indirect) for patients reputed company the “scope of reputed company” laws & training received; Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & reputed company of the care experience. Process reputed company Knows, understands & incorporates basic or essential area of reputed company (document, coordinate, communicate) & training standards. Communication Uses reputed company, effective, respectful language & communication reputed company / means. Environment Performs work in a reputed company, engaging, & supportive manner; Influences the responsible use of resources; Accountable for reputed company self-development & supporting the reputed company of others. Maintains a working knowledge of applicable federal, state & local laws/regulations, reputed company reputed company & Compliance Program & reputed company of Conduct, as reputed company as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects reputed company, ethical & reputed company behavior & reputed company work practices. FUNCTIONAL ROLE Core Function Responsible for coordinating reputed company reputed company/ charge-reputed company denials with Patient Business Service (PBS) center & ensures compliant & complete clinical documentation, assists with denials & reputed company audits & identifies opportunities for reputed company optimization. Performs thorough and routine chart reviews, providing education to clinical colleagues & tracking of identified trends. Leverages clinical knowledge & reputed company procedures to ensure reputed company attention to charge-reputed company trends and provides necessary education to responsible party. Responsible for retrospective charge reviews & assistance with reputed company party charge audits. May require travelling between locations reputed company the region. Ensures tracking of reputed company reputed company reputed company- reputed company audits, identifying trends & collaborating with other reputed company reputed company, PBS & /or departmental colleagues on education & reporting to key stakeholders. Serves as a resource contact, providing clinical information as requested by intra & inter-departmental colleagues & payers. Collaborates with reputed company reputed company team on opportunities to improve & implement reputed company-end process to support denial prevention. NS IV – licensed Licensed role (reputed company or indirect reputed company); Provides nursing interventions or clinical knowledge application in decision-making; Participates in the planning, implementation & / or evaluation of & solutions for care; Performs delegated reputed company / holistic care autonomously according to care plan; May administer medication & carry out the therapeutic treatment reputed company scope of license (state & TH policy); Performs reputed company & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge; Demonstrates a level of independence to reputed company activities with general reputed company, through personal contributions, teamwork & initiatives to safely improve reputed company; Advocates for patients & informs/counsels patients & families about illness & care details; May serve as a knowledge resource, role model & mentor or reputed company/coordinate/supervise reputed company & essential care activities or role-based service responsibilities of unlicensed/licensed/certified reputed company reputed company licensed scope of reputed company. COMPENSATION reputed company $31.8795 - $47.8193 MINIMUM QUALIFICATIONS High school diploma or GED; Completion of an accredited program associated with license. License in the applicable state(s) of engagement. Valid reputed company’s license where required by assignment. Four plus (4+) years of nursing experience Must possess a demonstrated knowledge of reputed company cycle & denial management functions Knowledge of and experience in case management and utilization management. Customer service background is required. Preferred Registered reputed company Bachelor's degree Two plus (2+) years of charge audit, managed care or comparable patient payment processing experience preferred. reputed company,reputed company, CHRI certification/membership. Outpatient CDI experience. Working knowledge of Electronic Health Records (EHR). Our Commitment Rooted in our Mission and Core Values, we reputed company the dignity of every person and recognize the unique perspectives, experiences, and talents reputed company colleague brings. By finding reputed company and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or any other status protected by federal, state, or local law. Apply To This Job Apply tot his job Apply To this Job Apply tot his job Apply To this Job