[Remote] DRG Denials-Registered Nurse

Remote Full-time
Note: The job is a remote job and is open to candidates in USA. United Audit Systems, Inc. (UASI) is a rapidly growing healthcare consulting firm seeking to expand its professional team by adding experienced Nurse Auditors. The role involves performing various audit services related to DRG Denials, reviewing and analyzing billing statements, and educating client-hospital personnel on documentation and validation processes. Responsibilities • Perform a variety of audit services including charge audit, compliance audit, medical necessity, denials and other requests as needed. Audits may be performed on a concurrent or retrospective basis • Review and analyze the client inpatient and/or outpatient itemized billing statement and the patient medical record and related documentation to identify items that were not billed correctly. • Document findings on appropriate form and submit findings to client management staff daily so new billing forms can be generated in hospitals billing systems. • Adhere to the National Health Care Billing Audit Guidelines, UASI Code of Conduct and Compliance Program, and the client third party audit policy while performing all duties. • Attend meetings with members of client-hospital finance, medical records, and ancillary departments. • Educate Client-Hospital personnel on validation and documentation of charges if requested by client contract relationship. • Navigate hospitals medical record system and understand where to locate the financial information in relation to the patient payor billing information. Skills • Medical clinical experience • Experience with DRG Denials • Ability to read and comprehend itemized billing statement, patient medical record and other laboratory reports • Ability to analyze medical information and determine appropriate billing procedures • Ability to effectively communicate with others • Analytical thinking process • Knowledge of basic computer skills • Epic experience • InterQual and Medical Necessity experience Benefits • Medical, dental, vision and life insurance • Short/long-term disability • 401(K) • Referral bonuses • Training opportunities and reimbursement for professional certifications • Birthday recognition • Holiday gift selections • Performance awards • Years of service awards Company Overview • Since 1984, UASI has been one of the largest independent healthcare revenue cycle consulting firms in the United States. It was founded in 1984, and is headquartered in Cincinnati, OH, US, with a workforce of 501-1000 employees. Its website is Apply tot his job
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