Job added in hotlist
Applied job
Contract job
90-day-old-job
part-time-job
Recruiter job
Employer job
Expanded search
Apply online not available
View more jobs in Anchorage, AK
View more jobs in Alaska
View Similar Jobs

Job Details

Nurse Auditor Review

Company name
Humana Inc.

Location
Anchorage, AK, United States

Employment Type
Full-Time

Industry
Healthcare, Nursing

Posted on
May 09, 2023

Apply for this job






Profile

Description

The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement.

Responsibilities

The Nurse Auditor 2 validates and interprets medical documentation to ensure capture of all relevant coding. Applies clinical and coding experience to conduct reviews of provider codes and billing.

Makes decisions of clinical appropriateness based on submitted provider information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

Active Registered Nurse (RN) license

CPT coding experience or certification

MS Office proficiency

18 months of medical record or coding auditing experience

Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information

Ability to work independently and manage work load

Excellent writing, editing, interpersonal, planning, teamwork, and communications skills

Experience applying CMS manual, NCCI edits, LCD / NCD documentation to audits

WORK HOURS : Monday-Friday, 5 days week, 8 hours per day, work must be performed/scheduled between 6AM-6PM EST.

This role will be performed 100% remotely/work at home.

Preferred Qualifications

Bachelor's Degree in relevant field preferred

Prospective payment methodologies, auditing experience

Clinical documentation improvement knowledge

Work at Home/Remote Requirements

Must ensure designated work area is free from distractions during work hours and virtual meetings

Must provide a high-speed DSL or cable modem for a workspace (Satellite, wireless and Hotspots are prohibited). A minimum standard speed of 25x10 (25mbs download x 10mbs upload) for optimal performance of is required

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com

I was facing the seven-year itch at my previous workplace. Thanks to EmploymentCrossing, I'm committed to a fantastic sales job in downtown Manhattan.
Joseph L - New York, NY
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
HealthcareCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
HealthcareCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2024 HealthcareCrossing - All rights reserved. 169 192