Swedish Medical Center Nurse Auditor - Billing Office in Seattle, Washington
Where you work matters! Swedish Medical Center is looking for a Full-Time Nurse Auditor to work Day Shift for the Billing Office at Metropolitan Park East in Seattle, WA.
The Nurse Auditor iwrites appeals on denied claims, analyze chart and split claims as needed, works account and claims edit work queues as needed, performs quarterly CARF (Commission on Accreditation of Rehabilitation Facility) audits, and verify charges on High dollar Medicare Claims.
In this position you will:
Schedules audits and assist with audits as requested by third party payors based on the criteria in the Swedish audit policy.
Meet with auditors, familiarize them with Swedish records, policies, etc., answer questions and be available as they conduct audits.
Conduct exit interviews with auditors going over their findings.
Review audit findings, obtain further documentation from hospital departments, and check accuracy of findings.
Finalize and sign-off with auditors on agreed upon final audit reports
Post audit findings on account, put through credit/debit adjustments, and put all findings.
Act as a resource for Patient Financial Services staff with questions regarding the medical record, verifying charges, etc. and other concerns by patients, staff members, and insurance companies.
Responds to patients and family members who have concerns about the bill and/or charges.
Assist Patient Financial Services staff in regards to edits in Epic and Emdeon or other third party claims editing systems
Required qualifications for this position include:
Nursing degree (BSN) from an accredited school of nursing. Applicants without a BSN degree must actively pursue and attain a BSN within five years of hire. Continued employment by Swedish beyond five years is contingent upon attaining the BSN degree
2 years clinical experience, with a broad range of clinical experience helpful.
Experience with researching and analyzing coding and charge or claim edits needed.
Current license to practice as a registered nurse in the State of Washington.
Preferred qualifications for this position include:
Working in an acute setting and ICU or Emergency room experience.
Case Management and writing appeals experience
Experience with researching and analyzing coding and charge or claim edits
About Swedish Shared Services
Swedish is the largest, most comprehensive, nonprofit health provider in the Greater Seattle area. Our expanding network of facilities currently includes three hospital locations in Seattle, a hospital in Edmonds and the new Swedish Issaquah campus. It also consists of Swedish Medical Group’s network of primary care clinics, and affiliations with suburban hospitals and specialty clinics throughout Greater Seattle.
Each campus has a local operations leadership team, supported by centrally located and led corporate services, such as Human Resources, Financial and Information Services.
We offer a full comprehensive range of benefits — see our website for details
Our nonprofit Mission is to improve the health and wellbeing of each person we serve. Our Vision is to demonstrate the highest-quality, best-value healthcare to all we serve.
Swedish is the largest nonprofit health care provider in the greater Seattle area. It is comprised of five hospital campuses (First Hill, Cherry Hill, Ballard, Edmonds and Issaquah); ambulatory care centers in Redmond and Mill Creek; and Swedish Medical Group a network of more than 118 primary care and specialty locations throughout the Puget Sound. Swedish employs more than 13,300 employees and 3,100 physicians and allied health professionals. Whether through physician clinics, education, research and innovation or other outreach, we’re committed to caring for the people in our region and beyond. Swedish is proud to be an Equal Opportunity Employer. Swedish does not discriminate on the basis of race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Nursing - Other
Work Locations: Metropolitan Park East (WA152) 1730 Minor Avenue Metropolitan East Tower Seattle, 98101
Req ID: 248160