Missouri Licensed Denial Nurse Auditor

Job Summary

A company is looking for a Remote - PFS Denial Nurse Auditor.

Key Responsibilities

• Complete clinical reviews of post-claim denials and prepare appeal letters
• Consult and provide appeal direction using payer guidelines during monthly denials meetings
• Ensure compliance with regulations governing patient services and reimbursement

Required Qualifications

• Bachelor's Degree - Graduate of a nursing school, BSN required
• Registered Nurse - State Licensure and/or Compact State Licensure required
• 5 years of experience in health care as a registered nurse, preferably in revenue cycle
• Excellent understanding of financial and health care strategies required