Nurse Auditor
Intermountain Healthcare - Murray, UT

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Provide expertise in the areas of clinical and coding practices to other areas within the organization. Review provider appeals, non covered services done at same time as covered services, unlisted codes, possibly covered services and other claims that require clinical and/or coding expertise for claims payment. This position will work with Medicare and Medicaid.

Minimum Requirements

RN licensed in the State of Utah, or license eligible

Five years of RN work experience

Three years of Care Management experience

Three years of health insurance experience

Experience in word processing, internet searches and spreadsheets

Preferred Qualifications

Bachelor's degree in nursing

Experience in training and auditing procedures

Clear understanding of health care products, ethics policies, and internal processes

Working knowledge of IDX, Clinical Workstation, AS400, LINC, OVID, and the Internet

Demonstrated teaching and leadership ability

Demonstrated ability in fostering organizational communication

Ability to communicate successfully, professionally and effectively with all individuals, professional and private, in writing and verbally

Ability to establish and maintain rapport with co-workers, physicians, other health care providers, clients

A working knowledge of managed care, ICD-9/CPT 4 coding, length of stay guidelines, and appropriate levels of care and modalities by diagnosis/procedure in multiple clinical areas

Able to work independently, and be self-motivated with a positive attitude and flexibility in a rapidly changing environment

Experience in utilization management

Coding certification from a nationally recognized organization (e.g. American Academy of Professional Coders - AAPC or "American Health Information Management Association � AHIMA).

Please Note
All positions subject to close without notice
Intermountain Healthcare is an equal opportunity employer M/F/D/V

Intermountain Healthcare - 2 years ago - save job - block
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Intermountain Healthcare is an internationally recognized system of 22 hospitals and a full range of medical services, multi-specialty...