Mosaic Life Care
Remote - PFS Denial Nurse Auditor
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Job Description
- Req#: req18809
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $96,616.00 per year
- Opportunity for career advancement and growth within the organization
- Work remotely from specified states, providing flexibility
- Engage in meaningful work that directly impacts patient care and financial outcomes
- Supportive and collaborative work environment with a focus on quality improvement
What to Expect (Job Responsibilities):
- Complete clinical reviews of post-claim denials and prepare appeal letters for denied accounts
- Consult clinical and hospital appeal guidelines and provide direction to departments during monthly denials meetings
- Ensure compliance with all federal, state, and local regulations governing patient services and reimbursement
- Analyze audit information and provide education to caregivers to improve quality indicators and outcomes
- Perform additional duties as assigned
What is Required (Qualifications):
- Bachelor’s Degree in Nursing; BSN is required
- Must possess a Registered Nurse (RN) license by the State of Missouri or Compact State Licensure
- Minimum of 5 years of experience as a registered nurse, preferably in revenue cycle
- Excellent understanding of financial and healthcare strategies
How to Stand Out (Preferred Qualifications):
- Experience in clinical denial management or appeals process
- Familiarity with payer guidelines and compliance regulations
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Mosaic Life Care provides health care and life care at a location near you in St. Joseph and the surrounding area. We are a Mayo Clinic Care Network member.
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