Remote - PFS Denials Nurse Auditor

Mosaic Life Care•Saint Joseph, MO

25d•Remote

About The Position

The Denials Nurse Auditor works under the supervision of the manager of PFS Denials. The Denials Nurse Auditor is responsible for completing, appealing, tracking, and reporting clinical denial reviews to determine the appropriate actions for post-billing denials. This Individual will combine clinical, financial, and regulatory knowledge and skill to reduce financial risk and exposure caused by payer denials for rendered services. The Denials Nurse Auditor has highly developed knowledge and skills in areas of: Medical Necessity, Authorizations, Experimental/Investigational denials, payer audits and filing appeals as well as Government and Non-Government payor requirements with Denial Management. Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.

Requirements

knowledge and skills in areas of: Medical Necessity
knowledge and skills in areas of: Authorizations
knowledge and skills in areas of: Experimental/Investigational denials
knowledge and skills in areas of: payer audits
knowledge and skills in areas of: filing appeals
knowledge and skills in areas of: Government and Non-Government payor requirements with Denial Management