UNC Health Care • Rocky Mount, NC 27803
Job #2660327549
Description
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
Summary:
The Recovery Audit Nurse will work closely with other Business Office staff members to assist in facilitating: 1) clinically related reviews of patient accounts/claims to ensure compliant billing guidelines (internal and external) are followed (including, but not limited to Discharge Disposition, Medicare 3-Day Rule, and Outpatient Facility-based Infusion and Hydration charging), 2) reviews and follow up of claims denied by insurance companies with primary focus on managed-care and commercial payers (will work closely with Case Management / Utilization Review staff), and 3) reviews and appeals for hospital patient accounts/claims denied payment through retrospective or prospective review, i.e. - Medicare and Medicaid RA (Recovery Auditor) programs.
Responsibilities:
Ensuring compliant billing guidelines
Assistance with hospital denial management program
Assistance with hospital audit response program
Organizational leadership skills
Collaboration and communication
Performs other duties as needed
Other information:
Education Requirements:
? Associate's degree in Nursing. Bachelor of Science in Nursing preferred.
Licensure/Certification Requirements:
? RN Licensed to work as a Registered Nurse in the state of North Carolina.
Professional Exp erience Requirements:
? Requires 2-3 years of Healthcare/Medical setting
Job Details
Legal Employer: Nash Hospitals
Entity: Nash UNC Health Care
Organization Unit: NGH Revenue Integrity
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job Monday-Friday 1st shift
Location of Job: NASH HC
Exempt From Overtime: Exempt: Yes
Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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