RN Audit Liaison

Summary:

• Responsible for oversight and coordination of payer audit requests.
• Functions as the primary audit liaison for case management, medical advisors, clinical and operational departments and patient financial services.
• Keeps audit activity current to prevent unnecessary financial burden.

Job Description:

• Participates and consults with internal experts to determine response on complex cases and coordinates the appeal process.
• Works closely with physician advisor, software vendor or other external resources associated with this initiative.
• Works with internal experts on prevention strategies.

Qualifications:

• Bachelor's Degree in health-related field or equivalent work experience.
• Registered Nurse (RN) license preferred, coding certification preferred.
• Maintains required department specific competencies and certifications.