Rev Audit Contract Appeals RN Job at Northwestern Memorial Healthcare, Warrenville, IL

UFpLSEdTb2Q3YmFGd0xPcmFGQTNjQVNKUXc9PQ==
  • Northwestern Memorial Healthcare
  • Warrenville, IL

Job Description



At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

Job Description



The Rev Audit Contract Appeals RN reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards.

Using clinical knowledge and evaluation of documented patient treatments, this position receives, interprets and facilitates appeals on insurance denials post payment, including payer escalation and other escalation methods to secure payment. This position is responsible for management of audits, including those from the Centers of Medicare & Medicaid Services (CMS). This position provides financial data and analysis for internal and external reporting and ensures the hospital is prepared for audits and responds to all audit requests.

AA/EOE

Qualifications



Required:

  • Licensed Registered Nurse (Current).
  • Minimum of 3 years in Acute Care Setting or in Audit/Appeals position.
  • Working knowledge of Miliman/Interqual guidelines.
  • Ability to analyze data; strong communication skills and ability to work cross functionally with other departments.

Preferred:

  • BSN in Nursing.
  • Knowledge of Medicare reimbursement policies.

Additional Information



Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Job Tags

Full time,

Similar Jobs

Connvertex Technologies Inc.

Network/Security Engineer Job at Connvertex Technologies Inc.

 ...Solid understanding of Routing & Switching technologies OR security infrastructure Experience working with Firewalls. Palo Alto...  ...patching and configuration of switchports Maintain inventory of network and telecom devices Monitor network/telecom infrastructure... 

University of Kansas

Pool - Lecturer - Chemical & Petroleum Engineering | University of Kansas Job at University of Kansas

 ...Teach one or more undergraduate or graduate courses in the Chemical or Petroleum Engineering field at the University of Kansas. Classes may be in-person, online, or a hybrid format. Applications will be reviewed and placed in a pool for consideration for part-time... 

ABC PEDIATRICS PA

Medical Practice Financial Officer/ Business Manager Job at ABC PEDIATRICS PA

 ...and experienced Financial Officer/Business Manager to oversee and streamline the financial and operational aspects of our practice. Benefits Competitive salary commensurate...  ...in financial management, ideally within a medical or healthcare setting. - Strong... 

Bridges Staffing

Tax Manager Job at Bridges Staffing

 ...Job Opportunity: Tax Manager Location : South Carolina, North Carolina, Georgia (Greater SE Region) Position : CPA, EA Experience Required: 4+ Years in Public Accounting with CPA Firm About Us: We are actively hiring various Tax Managers on behalf of our... 

Samsung SDS America

Technical Sourcing Recruiter Job at Samsung SDS America

 ...Samsung SDSA is looking for a technical sourcing recruiter to support our recruiting process from start to finish. Working alongside the...  ...requisitions, assignments. ~ Problem-solving aptitude. ~ Tech-savvy. ~ Technical expertise with an ability to understand...