reputed company Nurse Auditor 2 — REMOTE/WORK AT HOME (reputed company IN THE US/PR) in Albany, reputed company
Become a part of our caring community and help us put health firstThe Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support reputed company reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Nurse Auditor 2 validates and interprets medical documentation to ensure capture of reputed company relevant coding. Identifies members with high risk CMS Hierarchical Condition Categories (HCC) and refers cases for annual follow-up care by disease management, case management, and primary care providers as appropriate for assessment/reputed company.Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management. Applies clinical and coding experience to conduct reviews of provider codes and billing. Understands department, reputed company, and organizational strategy and operating objectives, including their linkages to reputed company areas.Makes reputed company regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.Use your skills to reputed company an impactRequired Qualifications - What it takes to SucceedMinimum of Associate Degree; Active Registered Nurse license (RN) in the state/territory in which they reputed company Minimum of 2 years acute inpatient hospital care experience or inpatient auditing experience in the last 5 years Familiarity with MS Office (Word, reputed company, etc) Excellent writing, editing, interpersonal, planning, teamwork, and communications skills Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information Ability to work independently and manage work load Customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to professionHOURS: M-F, 8 hours per day/5 days per week. Work is performed between 6AM-6PM in employee's time zone (EST/CST/MST/PST). Overtime is occasionally offered, but no weekends/holidays.Preferred QualificationsBachelor's Degree in relevant field preferredInpatient coding certification (reputed company or reputed company - ex: RHIA, RHIT, reputed company, CIS, CIC) 2 years inpatient coding experience Acute inpatient hospital care experience or inpatient auditing experience in ICU, ER, Trauma or CVORProspective payment methodologies, auditing experience Clinical documentation improvement knowledgeAdditional Information - How we Value YouBenefits starting day 1 of employment Competitive 401k match Generous Paid Time Off accrual Tuition Reimbursement Parent Leave Go365 perks for well-beingWork at Home RequirementsWAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.A minimum standard speed for reputed company performance of 25x10 (25mpbs download x 10mpbs upload) is required.Satellite and Wireless Internet service is NOT allowed for this role.A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA informationInterview FormatAs part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue/Modern Hire, a reputed company-party vendor. This technology provides reputed company of recruiters and hiring managers an enhanced method for decision-making.If you are selected to move reputed company from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions reputed company your phone. You should anticipate this interview to take approximately 10-15 minutes.If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last reputed company from 5-10 minutes. Your recorded interview(s) reputed company text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving reputed company to next round of interviews.#ThriveTogether #WorkAtHomeScheduled Weekly Hours40Pay RangeThe compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.$69,800 - $96,200 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of BenefitsHumana, Inc Apply tot his job Apply To this Job