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Nurse Auditor Non Exempt

Nurse Auditor Non Exempt

CompanyMedical University of South Carolina
LocationSouth Carolina, USA
Salary$Not Provided – $Not Provided
TypeFull-Time
DegreesBachelor’s
Experience LevelJunior

Requirements

  • Bachelor of Nursing degree preferred
  • A minimum of one year of work experience as a registered nurse required
  • Licensure as a registered nurse by the South Carolina Board of Nursing or a compact state
  • Current American Heart Association (AHA) Basic Life Support (BLS) certification or American Red Cross BLS for Healthcare Providers certification is required

Responsibilities

  • Responsible for the timely review of denied claims from all payers related to medical necessity, appropriate setting, status determination, authorizations, and appropriate length of stay
  • Ensure all denied claims are accurately worked and appealed to obtain maximum reimbursement and minimize recoupment
  • Actively manage, maintain, and communicate denial/appeal activity and/or emerging trends related to payer denials to denials manager and/or supervisor
  • Collaborate with other interdepartmental staff, clinicians, and/or non-clinicians

Preferred Qualifications

    No preferred qualifications provided.