RN Charge Auditor

at  Ascension

DETAILS

• Department: Recovery Audit Compliance
• Schedule: Full Time, Days, (M-F 8a-5p - some flexibility)
• Hospital: AW Glendale Corporate Office
• Location: Remote

REQUIREMENTS

Licensure / Certification / Registration:

• Registered Nurse credentialed from the Wisconsin Board of Nursing obtained prior to hire date or job transfer date required. Licensure from the Wisconsin Board of Nursing OR current home state license if considered multi-state/Compact State.

Education:

• Diploma from an accredited school/college of nursing OR Required professional licensure at time ofhire.

Coordinate payer denials and appeals, respond to insurance company requests for medical records, and perform medical record reviews.

• Review medical records to determine accuracy of billing through verification of coding, billing and supporting clinical documentation.
• Coordinate all activities associated with insurance carrier audit requests and works with payers to ensure timely handling of these payer audits.
• Review technical payer denials and determines whether an appeal is justified. Write and track technical appeal letters and relay information with billing department.
• Conduct audits to ensure accurate charge capture, enhance reimbursement and identify savings potential.