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Charge Registered Nurse (RN) - Surgery Auditor

Job ID: 226360
Charge Registered Nurse (RN) - Surgery Auditor
Mequon, Wisconsin
Regular/Day
Additional Job Information
Title: Auditor-Charge (RN)
City, State: Mequon,WI
Location: CSM Hospital Ozaukee
Department: Surgery
Additional Job Details: Full-Time,Day, 40 hours,Weekly
About Us
In Wisconsin, Ascension operates 24 hospitals and hundreds of related healthcare facilities that together employ more than 23,500 associates. Across the state, Ascension provided more than $230 million in community benefit and care of persons living in poverty in fiscal year 2016. Serving Wisconsin for 169 years, Ascension is a faith-based healthcare organization committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Ascension is the largest non-profit health system in the U.S. and the world?s largest Catholic health system, operating 2,500 sites of care ? including 141 hospitals and more than 30 senior living facilities ? in 24 states and the District of Columbia. Visit www.ascension.org/wisconsin. We?re looking for talented associates to join us as we continue advancing healthcare across Wisconsin.
Job Description
Job Summary:
Coordinates payer denials and appeals, responds to insurance company requests for medical records, and performs medical record reviews.
Responsibilities:
+ Reviews medical records to determine accuracy of billing through verification of coding, billing and supporting clinical documentation.
+ Coordinates all activities associated with insurance carrier audit requests and works with payers to ensure timely handling of these payer audits.
+ Reviews technical payer denials and determines whether an appeal is justified. Writes and tracks technical appeal letters and relay information with billing department.
+ Conducts audits to ensure accurate charge capture, enhance reimbursement and identify savings potential.
Qualifications
Licenses/Certifications/Registration:
+ Required Credential(s):
+ Licensed Registered Nurse credentialed from the Wisconsin Board of Nursing or current home state license for multi-state license recognition "Compact State" obtained prior to hire date or job transfer date.
Education:
+ Bachelor's Level Degree
+ Bachelor's degree required Bachelor's degree in Business Administration or Healthcare Management preferred
Work Experience:
+ Three years previous HIM or coding related experience required. Knowledge of Medicare billing regulations and charge master components (CPT, HCPCS, APC's, revenue and modifier codes) required. FOR SURGICAL SERVICES ONLY: Knowledge of surgical procedures and charging processes preferred.
How To Apply
We urge you to apply to any/all positions that you have interest in. If you fit the qualifications for the role, we will reach out to you. Please ensure you complete all required fields within the application (indicated with an asterik), as well as additional information that is requested of you. Information that you offer us will better assist us in understanding your qualifications and fit for the position(s) you've applied for.
For questions or assistance with completing the online application, please contact Ascension Candidate Care at 855-778-6037.
Also to note, our online application system may not be compatible with non-Windows based operating systems (iPhones, iPads, or Mac computers).
Equal Employment Opportunity
Ascension Wisconsin is an equal opportunity employer and will not discriminate against employees or prospective employees on basis of age, race, creed, color, religion, marital status, sex, national origin, ancestry, citizenship, sexual orientation, disability, arrest and/or conviction record, military status, protected veteran status, or any other characteristic or status protected by law.
For further information regarding your EEO rights, click on the following link to the ?EEO is the Law? poster:
http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf
M/F/Disabled/Vet
EEO is the Law Poster Supplement
http://www.dol.gov/ofccp/regs/compliance/posters/pdf/ofccp_eeo_supplement_final_jrf_qa_508c.pdf


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