Wisconsin Licensed Nurse Auditor

Marshfield Clinic Health System; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare organization is seeking a Nurse Auditor - Revenue Integrity to work remotely in Wisconsin. This role involves reviewing medical records, providing coding guidance to staff, and developing appeals correspondence for payors. Candidates must hold a nursing diploma or associate's degree, possess a Wisconsin RN license, and have a minimum of three years' experience in a medical setting. Additionally, coding certification is required within three years of hire.

Qualifications

• Minimum of three years' experience in a medical setting or medical business office.
• Coding certification from AAPC, AHIMA, or an approved entity must be obtained within three years of hire.

Responsibilities

• Review medical records to ensure proper coding for assigned specialties.
• Provide guidance to physicians and staff regarding coding and Medicare/Medicaid policies.
• Develop appeals correspondence materials for payors or Recovery Audit Contractors.

Skills

Knowledge of CPT, ICD-9/ICD-10, and HCPCS coding

Guidance to physicians and staff

Reviewing medical records

Education

Nursing diploma or Associate's degree in nursing

Registered Nurse license from the State of Wisconsin

Job description

A company is looking for a Nurse Auditor - Revenue Integrity (Remote in Wisconsin).

Key Responsibilities

• Review medical records to ensure proper coding for assigned specialties
• Provide guidance to physicians and staff regarding coding and Medicare/Medicaid policies
• Develop appeals correspondence materials for payors or Recovery Audit Contractors

Required Qualifications, Training, and Education

• Nursing diploma or Associate's degree in nursing required; Bachelor's degree preferred
• Minimum of three years' experience in a medical setting or medical business office
• Registered Nurse license from the State of Wisconsin required
• Coding certification from AAPC, AHIMA, or an approved entity must be obtained within three years of hire
• Knowledge of CPT, ICD-9/ICD-10, and HCPCS coding preferred