Rev Audit Contract Appeals RN
Rev Audit Contract Appeals RN
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Salary Not Disclosed
1 Vacancy
Job Description
The Rev Audit Contract Appeals RN reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.
Using clinical knowledge and evaluation of documented patient treatments this position receives interprets and facilitates appeals on insurance denials post payment including payer escalation and other escalation methods to secure payment. This position is responsible for management of audits including those from the Centers of Medicare & Medicaid Services (CMS). This position provides financial data and analysis for internal and external reporting and ensures the hospital is prepared for audits and responds to all audit requests.
AA/EOE
Qualifications :
Required:
- Licensed Registered Nurse (Current).
- Minimum of 3 years in Acute Care Setting or in Audit/Appeals position.
- Working knowledge of Miliman/Interqual guidelines.
- Ability to analyze data; strong communication skills and ability to work cross functionally with other departments.
Preferred:
- BSN in Nursing.
- Knowledge of Medicare reimbursement policies.
Additional Information :
Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age sex race color religion national origin gender identity veteran status disability sexual orientation or any other protected status.
Benefits
We offer a wide range of benefits that provide employees with tools and resources to improve their physical emotional and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.
Remote Work :
No
Employment Type :
Full-time
Employment Type
Full-time
