Job Information
FROEDTERT HEALTH, INC Medical Audit Services Coord FCH in MENOMONEE FALLS, Wisconsin
JOB REQUIREMENTS: Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility. This job is REMOTE. FTE: 1.000000 Shift: FLEXIBLE 1st shift 7 am to 5 pm Job Summary: Responsible for managing and coordinating all medical audit services in the Patient Financial Services (PFS) department. Identifies opportunities for process improvement in the charging and documentation of services and assists departments in implementing process improvements. Coordinates Denials Management program. Other duties as assigned. Complete timely and accurate appeals to third party payors. Identify, and rectify inaccuracies with billing and reimbursement by analyzing accounts using financial, contract, and clinical information to ensure accurate and complete payment of claims by third party payors. Review coding and other information available in the patient\'s medical records to substantiate accuracy of billing information or to support the appeal of an incorrect denial or reimbursement from a third party payor. Submit the proper appeal form and supporting documentation to the payor and contact payor representatives to negotiate correct payment to the hospitals. Consults with Case Management, Medical Directory, and attending physician as needed regarding medical necessity and level of care status issues. Coordinate activity involving Organ Procurement charging and billing Ensure correct bed charging matches order EXPERIENCE DESCRIPTION: Three to five years of experience auditing medical records and patient bills is required.EDUCATION DESCRIPTION: Bachelor\'s degree in Nursing is required.LICENSURE DESCRIPTION: Requires current state of Wisconsin Registered Nurse License or a Multi-state Nursing License from a participating state in the NLC (Nurse Licensure Compact). Perks & Benefits at Froedtert Health Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following: Paid time off Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities Academic Partnership with the Medical College of Wisconsin Referral bonuses Retirement plan - 403b Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits... For full info follow application link. We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. As a federal contractor/subcontractor, we take affirmative action in employment based on race, sex, disability and status as a protected veteran. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/D66D9F0E8838404F