Registered Nurse - Payment Auditor - New York City
On Time Talent Solutions
: $83,450.00 - $117,470.00 /year *
: Healthcare - Nursing
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Job DescriptionRegistered Nurse ?? Payment AuditorNew York City, NYPerforms post-payment clinical auditing in defense of hospital charges. This position audits patient records to evaluate medical necessity and charge capture in an effort to minimize hospital losses; conducts requested audits to ensure consistency between medical records documentation and billing statements on patient accounts and submits appeals to payers on patient account denials when appropriate.Registered Nurse ?? Payment Auditor Responsibilities:Conducts reviews and responding to insurance denialsWrites concise, factual letters and provides medical record documentation to support appealEffectively communicates verbally with external and internal customers to ensure argument for appeal is clearly presentedPrioritizes and organizes own work to meet appeals and grievance deadlinesResponsible for the denials process, including subsequent appeal to health insuranceReviews for completeness of documentation based on chargesReviews charges for completeness and accuracy based on documentationDetermines if charges supported by documentation have been missedDemonstrates awareness of departmental charging procedures and serves as a liaison between department managers and Patient Financial Services.Demonstrates awareness of payer specific reimbursement methodologies and payer specific policies and procedures regarding charging, coding, billing, claim processing, and dispute resolution to assist patients and employees.Assists and educates patient representatives regarding pricing questions and item descriptions as needed to increase efficiencyPerforms patient inquiry audits as requestedProvides audit results and written explanation of line items (if needed) to the patient representative or supervisorRegistered Nurse ?? Payment Auditor Qualifications:Associate's Degree Graduate from an accredited NLN/CCNE institution required2 years RN experience requiredNursing/RN - Registered Nurse - State Licensure and/or Compact State Licensure requiredFor more information please call 763-###-#### or simply apply!SDL2017 Associated topics: care unit, coronary, hospice, intensive, intensive care, intensive care unit, nurse clinical, nurse rn, registered nurse, surgical