Overview:
The Clinical Denial Management Nurse Auditor is responsible for completing, tracking, and reporting clinical denials at an enterprise level between all UF hospitals. Reporting to Enterprise Denial Management Manager, this role serves as a support to revenue cycle including clinical departments, finance, accounting, compliance, patient financial services, revenue integrity, managed care, utilization review, and patient access.
The Clinical Denial Management Nurse Auditor is considered a clinical expert in denial management and ensures all denied claims are accurately worked from a clinical perspective, and appropriately appealed to secure maximum reimbursement and minimize organizational write-offs.
Qualifications:
Minimum Education and Experience Requirements:
Required: LPN or RN
Required: 2-3 years Clinical experience as RN or 3-5 years clinical experience as a LPN
Preferred: CPC, COC, CCS
Preferred: Knowledge or experience related to coding, medical record review, auditing, insurance experience.
Motor Vehicle Operator Designation:Employees in this position:
Will operate vehicles for an assigned business purpose as a non-frequent driver
Licensure/Certification/Registration:
Required: LPN or RN licensure from state of Florida
