- MD Anderson Cancer Center (Houston, TX)
- …includes conducting retrospective reviews and audits of patient accounts to complete Defense Audits. *Ideal Candidate:* A *Registered Nurse (RN)* with experience ... to justify appeals. * Evaluate and audit medical records to support Defense Audits, confirming services were provided and billed accurately. Review for overcharges… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and compliance functions necessary to effect accurate and complete ... services due to medical necessity or appropriateness of services. + Conducts compliance, defense , LifeNet and special focus audits and reports findings. + Serves as… more
- St. Luke's University Health Network (Allentown, PA)
- …+ Participate in Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding appeals, as needed. ... coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with supporting… more