Clinical Appeal Revenue Integrity Nurse Auditor

Job description

Overview CentraState Healthcare System, headquartered in Freehold, New Jersey, is a leading nonprofit healthcare provider dedicated to serving the community. Its comprehensive network includes CentraState Medical Center, a community-focused hospital, along with an ambulatory campus, two senior living facilities, three free-standing community health pavilions, and a charitable foundation. As the third-largest employer in Monmouth County, CentraState has earned repeated recognition as a Great Place to Work-Certified™ company, reinforcing its reputation as an exceptional workplace. CentraState currently has an employment opportunity available for a Clinical Appeal Revenue Integrity Nurse Auditor .This role is responsible for auditing documentation, ensuring documentation meets medical necessity requirements, constructs appeal letters, following all federal, state and payer requirements. They serve as a liaison between clinical, coding, billing, compliance, and finance teams to promote best practices in revenue cycle operations.They will work with hospital departments including Case Management/Utilization Review, Health Information Management, Patient Financial Services, Ancillary Depa...