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Registered Nurse


Mid Level


Not defined

24 Dec → 23 Jan

Atrium Health

Charlotte, NC, USA

About Company

Atrium Health is a nationally recognized leader in shaping health outcomes through innovative research, education and compassionate patient care. Atrium Health is an integrated, not-for-profit healthcare system with over 55,000 teammates at nearly 40 hospitals and hundreds of care locations throughout the Carolinas and Georgia. Atrium Health provides top-ranked pediatric, cancer and heart care to patients, as well as specialized musculoskeletal programs and organ transplants.
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Job Description

Registered Nurse who is responsible for performing Audits and Clinical Appeals as related to medical necessity, appropriateness of patient status and providing education and guidance to practitioners and other team members.

Job Responsibilities

  • Identifies accounts and actions to secure compliance for Medicare and Medicaid.
  • Prepares and processes appeals on denied accounts in a timely manner. This includes an assessment of the account, strategy plan and written communication designated by governmental agents as outlined for the appeal process.
  • Performs audits as outlined by governmental guidelines for charges and billing accuracy.
  • Functions as a liaison with governmental agencies to facilitate the audit process as needed through written and verbal communication.
  • Functions as a resource for education for Charlotte Metro facilities and regional facilities as outlined.
  • Interfaces and collaborates with Clinical Care Management and Coding to ensure appropriate level of care has been met and billing is compliant with both.
  • Develops and presents educational materials related to issues identified.
  • Communicates with internal and external customers in relation to regulatory guidance.
  • Maintains current knowledge of Interqual, Medicare and Medicaid guidelines.

Requirements / Qualifications

  • Graduate of an accredited program of Nursing required.
  • Current NC RN license required.
  • 1 - 3 years of hospital nursing experience in various clinical areas.
  • BSN preferred.
  • Basic Life Support for Healthcare Provider (BLS HCP) from AHA required.
  • Demonstrates analytical ability, initiative and resourcefulness.
  • Microsoft Office experience preferred.

How To Apply

Apply through GoRemotely.

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