RN - Clinical Auditor (Financial Operations)

Our Financial Operations Department is seeking an RN - Clinical Auditor to join our team! This position performs charge audits for patient appeals, grievances and reconsideration for denied payments. This position will work closely with various departments to verify services provided and total billed charges on all types of audits. Communicate all audit findings with the necessary parties and work closely with external auditors to obtain resolution of disputes. Types of audits include: Managed Care Defense, Patient Requests, AHCCCS, and other special request audits. Minimum Requirements: (3-5) Three to five years-clinical RN experience. Two years Utilization Review, Charge Audit, Case Management or related experience. Associates Degree. Completion of RN Program. Knowledge of hospital billing and charging processes, and understanding of Medical Terminology. Understanding of rules and guidelines to include American Association of Medical Audit Specialists (AAMAS), and National Commission on Insurance Guidelines and Medicare billing guidelines (CMS). Strong verbal and written communication skills. Knowledge of hospital billing and charging processes, and understanding of Medical Terminology. AZ RN License #LI-DH Hello humankindness Located conveniently in the heart of Phoenix, Arizona, St. Joseph"s Hospital and Medical Center is a 450+ bed, not-for-profit hospital that provides a wide range of health, social and support services. We are extremely proud to be a nationally recognized center for quality tertiary care, medical education and research. St. Joseph"s includes the internationally renowned Barrow Neurological Institute, St. Joseph"s Heart & Lung Institute, the University of Arizona Cancer Center at St. Joseph"s, and St. Joseph"s Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high-risk obstetrics, neuro rehabilitation, orthopedics, and other medical services. U.S News & World Report routinely ranks St. Joseph"s among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph"s boasts the Creighton University School of Medicine at St. Joseph"s, a strategic alliance with Phoenix Children"s Hospital, and a partnership with The University of Arizona Cancer Center. Founded in 1895 by the Sisters of Mercy, St. Joseph"s was the first hospital in the Phoenix area. More than 117 years later, St. Joseph"s remains dedicated to its mission of caring for the poor and underserved. St. Joseph"s is consistently named an outstanding place to work and one of Arizona"s healthiest employers. Come grow your career with one of Arizona"s Most Admired Companies Look for us on Facebook and follow us on Twitter For the health of our community ... we are proud to announce that we are a tobacco-free campus. Equal OpportunityDignity Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected Veteran status or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here .