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Remote RN- Government Denials Appeal Coordinator

at Baptist Memorial Health Care in MEMPHIS, Tennessee, United States

Job Description

Exciting Remote Opportunity in Baptist Corporate Revenue Audit Department

Medicare / Medicaid Appeals Registered Nurse reviews and evaluates medical documentation to

support billing compliance and external regulatory requirements.

Job Responsibilities

Abstracts pertinent information from the medical record to create appeals for cases denied by

governmental payors.

Educates department staff to issues related to the reimbursement process, as well as other concerns

that result from monitoring activities. Responsible for resolving issues as they occur. Other duties as assigned. auditorcase management

clinical documentation

analyst

Specifications

Experience

Description Minimum Required

Required 2 years of healthcare

care experience as RN

PREFERRED 5 years of

healthcare care experience and

3 years in Medicare billing

environment. Previous audit

experience, knowledge of

InterQual and Medicare Billing

practices.

Education

Description Minimum Required

Diploma RN or RN AD BSN

or RN with BS/BA in

Business Administration or

Management

Training

Description Minimum Required

Successful demonstration and

detailed understanding of

Hospital Revenue Cycle, CPT

codes, HCPC codes, modifiers,

and the Medicare/Medicaid

Appeals Process. Familiarity of

billing regulations including

federal and guidelines. Must

have excellent communication

skills and proven ability to

present.

Special Skills

Description Minimum Required Preferred/Desired

Strong knowledge of state and

federal healthcare laws and

regulations. • Understanding of

CMS coverage and payment

methodologies

Licensure

Description Minimum Required

RN

BOT Position Code #: 12472

Day Shift: Yes

Night Shift: No

External Company Name: Baptist Memorial Health Care Corporation

External Company URL: http://www.baptistonline.org

Street: 350 NORTH HUMPHREYS BLVD

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Job Posting: JC197545384

Posted On: Nov 13, 2021

Updated On: Dec 08, 2021