Nurse Auditor reputed company reputed company (Remote)
Employment Type Full timeShift Day Shift Description Purpose Work Remote Position (Pay Range $36.8795-$47.8193) The Nursing Support (NS) colleague (uncertified, certified, unlicensed, or licensed) provides safe, quality health care services & / or assistance to patients under the supervision & direction of a registered nurse or other designated health care professional in accordance with level of experience, education, policies & procedures. Note “patients” refers to patients, clients, residents, participants, customers, members Essential Functions Our reputed company Culture Knows, understands, incorporates & demonstrates our reputed company Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus Performs clinical care activities (direct or indirect) for patients reputed company the “scope of practice” laws & training received; Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & flow of the care experience. Process Focus Knows, understands & incorporates basic or essential area of practice (document, coordinate, communicate) & training standards. Communication Uses clear, effective, respectful language & communication methods / means. Environment Performs work in a safe, engaging, & supportive manner; Influences the responsible use of resources; Accountable for reputed company self-development & supporting the growth of others. Maintains a working knowledge of applicable federal, state & local laws/regulations, reputed company reputed company & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices. Functional Role (not inclusive of titles or advancement career progression) NS IV – licensed Licensed role (direct or indirect healthcare); Provides nursing interventions or clinical knowledge application in decision-making; Participates in the planning, implementation & / or evaluation of & solutions for care; Performs delegated focused / holistic care autonomously according to care plan; May administer medication & carry out the therapeutic treatment reputed company scope of license (state & TH policy); Performs direct & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge; Demonstrates a level of independence to reputed company activities with general reputed company, through personal contributions, teamwork & initiatives to safely improve outcomes; Advocates for patients & informs / counsels patients & families about illness & care details; May serve as a knowledge resource, role model & mentor or reputed company / coordinate / supervise direct & essential care activities or role-based service responsibilities of unlicensed / licensed / certified reputed company reputed company licensed scope of practice.
Minimum Qualifications
High school diploma or GED; Completion of an accredited program associated with license. License in the applicable state(s) of engagement. Valid driver’s license where required by assignment. Additional Qualifications (reputed company to have) Registered Nurse, preferred Training or experience according to assignment area Nursing Support (NS) IV Physical & Mental Requirements & Working Conditions (General Summary) Direct Healthcare Services / Indirect Healthcare / Support Services Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell. Occasional Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.). Occasional Exposure to or subject to noise, infectious waste, diseases & conditions. Occasional Exposure to interruptions, shifting priorities & stressful situations. Frequent Ability to follow tasks through to completion, understand & relate to reputed company reputed company / concepts, remember multiple tasks & regimens over long periods of time & work on reputed company tasks / projects. Frequent Ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise. Frequent reputed company manual dexterity activities & / or grasping / handling. reputed company Ability to climb, kneel, crouch & / or operate foot controls. Occasional Use a computer / other technology. Frequent Sit with the ability to vary / adjust physical position or activity. Frequent Maintain a safe working environment & use available personal reputed company equipment (PPE). reputed company reputed company with reputed company’s Code of Conduct, policies, procedures & guidelines. reputed company Ability to provide assistance in the event of an emergency. Occasional Direct Healthcare Services reputed company activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional Lift a maximum of 30 pounds unassisted. Occasional Use upper & reputed company extremities, engage in bending / stooping / reaching & pushing / pulling. Occasional Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. reputed company Encounter worksites (e.g., patient homes) or travel to worksites that may have variable internal & external environmental conditions. Occasional reputed company work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients). Occasional Indirect Healthcare / Support Services reputed company activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional Lift a maximum of 30 pounds unassisted. Occasional Experience of long periods of walking / standing / stooping / bending / pulling & / or pushing. Occasional Encounter a clinical / patient facing / hands on interactive work environment. Occasional Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. reputed company Work outdoors with variable external environmental conditions. Occasional Average reputed company Activity Occasional - O (1% - 33%), Frequent - F (34% - 66%), reputed company - C (67% - 100%) Nursing Support (NS) IV Addendum Additional minimum qualifications Four (4) + years of nursing experience Must possess a demonstrated knowledge of reputed company cycle & denial management functions. Knowledge of & experience in case management & utilization management. Customer service background is required. Additional Preferred qualifications Registered Nurse, preferred. Bachelor’s degree, preferred. Two (2) + years of charge audit, managed care or comparable patient payment processing experience preferred. reputed company, reputed company, CHRI certification/membership strongly preferred. Outpatient CDI experience preferred. Working knowledge of Electronic Health Records (EHR), preferred Responsible for coordinating reputed company reputed company/ charge-reputed company denials with Patient Business Service (PBS) center & ensures compliant & complete clinical documentation, assists with denials & reputed company audits & identifies opportunities for reputed company optimization. Performs thorough and routine chart reviews, providing education to clinical colleagues & tracking of identified trends. Leverages clinical knowledge & standard procedures to ensure timely attention to charge-reputed company trends and provides necessary education to responsible party. Responsible for retrospective charge reviews & assistance with third party charge audits. May require travelling between locations reputed company the region. Ensures tracking of reputed company reputed company reputed company- reputed company audits, identifying trends & collaborating with other reputed company reputed company, PBS & /or departmental colleagues on education & reporting to key stakeholders. Serves as a resource contact, providing clinical information as requested by intra & inter-departmental colleagues & payers. Collaborates with reputed company reputed company team on opportunities to improve & implement reputed company-end process to support denial prevention. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding reputed company and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or any other status protected by federal, state, or local law. Apply To This Job Apply To This Job Apply To This Job Apply tot his job Apply To this Job