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Medical Audit Nurse Coordinator - Atrium Health - Audit and Appeals - FT

Charlotte, NC, United States
Job ID: 4165
Job Family: Nursing
Specialty: Hospital Medicine
Status: Full Time
Shift: Day
Shift Details: Regular
Department Name: 51011028341294-Audit and Appeals
Location: Atrium Corporate Operations

Overview

Job Summary

Assesses, plans, coordinates and evaluates department operations and functions in conjunction with Medical Audit Manager to ensure regulatory compliance in the area of Medicare and Medicaid billing, process compliance with audits for correct third party billing and reimbursement, and cost effective and high quality appeals are submitted to payers. Acts as a resource within the department and interdepartmentally and is responsible for the supervision of audit team using the guidelines, policies, and procedures established by the department and the SBO.



Essential Functions

  • Assists Manager with hiring, training and disciplinary action, if necessary for all assigned teammates.
  • Assists departmental manager with preparation of annual performance appraisals and department goals.
  • Creates, maintains, and implements departmental policies and procedures.
  • Oversees and actively maintain 72 hour and ARC requirements to meet billing compliance regulations.
  • Oversees denials and appeals process to overturn clinical denials.
  • Oversees orientation and training of departmental team in conjunction with manager.
  • Functions as an interdepartmental liaison to promote teamwork.
  • Assumes managerial role in absence of manager.

Physical Requirements

Environment requires the ability to concentrate, analyze information and sit for long periods of time. Frequent interruptions require flexibility in performance of duties. May requires some travel and use of personal vehicle. Excellent Oral and Written Communication Skills. Demonstrate analytical ability, initiative and resourcefulness.



Education, Experience and Certifications

Graduate of an accredited program of nursing required. BSN preferred. Current Registered Nurse licensure by the Board of North Carolina Nursing required.