Revenue Cycle Audit Contract Appeals RN - Remote

Overview

This position reflects the mission, vision, and values of Northwestern Medicine, focusing on recovering lost revenue due to post-payment denials and performing audits.

In Short

• Work to recover lost revenue from post-payment denials.
• Perform charge and record audits.
• Interpret and facilitate appeals on insurance denials.
• Manage audits from the Centers of Medicare & Medicaid Services (CMS).
• Provide financial data and analysis for reporting.
• Ensure preparedness for audits and respond to requests.
• Collaborate with other departments.
• Utilize clinical knowledge in decision-making.
• Adhere to ethical and compliance standards.
• Support a positive workplace culture.

Requirements

• Licensed Registered Nurse (Current).
• Minimum of 3 years in Acute Care or Audit/Appeals position.
• Knowledge of Miliman/Interqual guidelines.
• Ability to analyze data and communicate effectively.
• BSN in Nursing preferred.
• Knowledge of Medicare reimbursement policies preferred.

Benefits

• Competitive benefits including tuition reimbursement.
• Loan forgiveness options.
• 401(k) matching.
• Lifecycle benefits for employee well-being.
• Resources for physical, emotional, and financial health.