Top 10 Nurse auditor Jobs in New York Ny

Nurse Auditor
Jzanus Consulting —Garden City, NY
- From $87,000 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Word processing
- Health insurance
- Dental insurance
Medical Analyst: Legal Nurse, Medicaid Fraud Cases (6448)
State of New York - Attorney General, Office of the —New York, NY
- $82,953 - $86,953 a year
- Full-time
- Background check
- Nursing
- 7 years
- Health insurance
- Dental insurance
Special Investigations Unit Clinical Certified Coder
MetroPlus Health Plan —New York, NY
- $100,000 - $110,000 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- 5 years
School Nurse (26-27 SY)
Lead Charter School —Newark, NJ
- Full-time
- CPR Certification
- Nursing
- RN License
- Disability insurance
- Health insurance
School Nurse
LEAD CHARTER SCHOOL —Newark, NJ
- Full-time
- CPR Certification
- Experience working with individuals with disabilities
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
Part-Time School Nurse
Lead Charter School —Newark, NJ
- Part-time
- CPR Certification
- Nursing
- RN License
NURSE (26-27 SY)
Community Charter School of Paterson —Paterson, NJ
- $64,000 - $90,000 a year
- Full-time
- RN License
- Mid-level
- Bachelor's degree
- Health insurance
- Paid time off
Quick Apply
Substitute School Nurse
Community Charter School of Paterson —Paterson, NJ
- $50 an hour
- RN License
- Mid-level
- Bachelor's degree
- Health insurance
- Paid time off
Quick Apply

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Certified Medical Coder
MJHS —New York, NY
Required coding certification (CCS-P or CPC through AHIMA/AAPC). Intermediate Excel, MS Word, Access data entry and report generation.
$61,463.13 - $73,755.75 a year
MRU Nurse Coder
Catholic Health —Farmingdale, NY
Current NY Registered Nurse (RN) license required. Ensure proper clinical coding and case-mix accuracy. Experience with clinical documentation review, coding,…
$90,000 - $110,000 a year

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Nurse Auditor

Jzanus Consulting -
Garden City, NY

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Job Details

Full-time
From $87,000 a year

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Flexible schedule
Life insurance

Qualifications

RN License
Health insurance policy knowledge
Desktop applications
Productivity software
Quantitative analysis
Cross-functional communication

Full Job Description

JOB SUMMARY:

The Nurse Auditor will have full responsibility to audit patient charts (i.e., medical record) and respond to insurance denials. The audit is conducted to ensure that the clinical documentation contained within the patient chart supports items and services that appear on the patient’s bill, and to ensure that all items and services provided are included on the patient bill. Where clinical documentation does not support items appearing on the bill, the Nurse Auditor will prepare a report of exceptions and offer solutions. The Nurse Auditor will ensure complete and timely responses to the requestor of the audit.

QUALIFICATIONS:

Associates or Bachelor of Science in Nursing required.

Strong Computer and software skills required for effective remote work.

Registered Nurse licensed in New York preferred.

3+ years’ experience in hospital setting preferred.

Auditing experience preferred.

Knowledge of CPT/HCPCS procedural coding and Charge Description Masters strongly preferred.

Experience with PCs, word processing, spreadsheet, graphics, and database software applications is desired.

Ability to work independently & cooperatively, efficiently, and accurately prioritizing varying workloads required.

Strong quantitative, analytical, and organization skills required.

Must be able to understand all ancillary department functions.

Must be able to understand insurance terms (i.e. HMO/PP, EOB, stop loss, etc.) and payment methodologies. Excellent communication skills required. Positive attitude to work effectively with staff and clients required.

SPECIFIC ESSENTIAL FUNCTIONS:

Additional Skill Set(s) Required:

1. Coordinates all procedural and other elements related to the Centers for Medicare & Medicaid Recovery Audit Contractor program, commercial payor audits, patient requested audits and charge capture auditing.

2. Audits and reconciles services and items included in the patient’s chart with services and items included on the patient’s bill in a timely manner. Where exceptions are noted, suggested solutions are offered.

3. Identifies and prepares charges to be corrected on accounts.

4. Pre-reviews accounts being audited by Government Agencies.

5. Meets required timelines for all audit activities.

6. Works fluidly with Audit Team to communicate audit results.

7. Reviews medical records for accuracy and billing compliance as support for billers and coders, for medical necessity and where appropriate works through the hospital HIM and financial departments to identify physician and clinic practices that require improved documentation.

8. Organizes and reconciles daily work drivers to ensure accountability of all audits assigned and to ensure audits are worked in proper priority.

9. Keeps updated on various billing rules to ensure charges that are identified in audits are split and rebilled properly.

10. Conducts trend analyses to identify patterns in audit requests and outcomes for medical necessity, coding and billing practices.

11. Functions as a liaison to resolve any related charge/coding issues or problems that occur in or are identified during the audit process.

12. Instructs and teaches. Performs ancillary service quality assurance reviews and audits, and meets with the Managers and staff to instruct and inform on documentation findings to increase accuracy in billing; recommends solutions to improve charge capture accuracy.

13. Excellent communication skills necessary to deal with many departments regarding billing issues and required solutions.

14. Performs other duties as assigned.

Job Type: Full-time

Pay: From $87,000.00 per year

Benefits:

401(k)

401(k) matching

Dental insurance

Flexible schedule

Health insurance

Life insurance

Paid time off

Vision insurance

Schedule:

Monday to Friday

License/Certification:

RN License (Required)

Ability to Relocate:

West Hempstead, NY 11552: Relocate before starting work (Required)

Work Location: Hybrid remote in West Hempstead, NY 11552

About Jzanus Consulting

For over 25 years, Jzanus has been a premier provider of revenue integrity HIM services. Quality and trust, along with personal and professional integrity have been the cornerstones upon which we built our reputation and our success. Jzanus’s accomplishments are the result of our New York best practice experience, our proprietary technology platform and most importantly the Jzanus team. Our people are senior level professionals with extensive provider, payer, clinical, HIM and home care experience who are very aware of the business challenges that face you daily. Jzanus Consulting specializes in providing HIM coding validation, clinical documentation improvement, and cost outlier recovery to hospitals and hospital-owned physician organizations. We have earned the trust of our customers by utilizing only the most qualified HIM consultants. By ensuring compliance and coding accuracy for optimal reimbursements, we provide significant value to our customers.

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nurse auditor jobs in new york ny

Nurse Auditor

Medical Analyst: Legal Nurse, Medicaid Fraud Cases (6448)

Special Investigations Unit Clinical Certified Coder

School Nurse (26-27 SY)

School Nurse

Part-Time School Nurse

NURSE (26-27 SY)

Substitute School Nurse

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JOB SUMMARY:

QUALIFICATIONS:

SPECIFIC ESSENTIAL FUNCTIONS:

Additional Skill Set(s) Required:

Benefits:

Schedule:

License/Certification:

Ability to Relocate:

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