Full time, Full Time
MUSC Health
Charleston, SC, USA
Job Description Summary The RN Nurse Auditor is a key member of the Clinical Appeals team and reports directly to the Clinical Appeals Manager. This role is responsible for conducting clinical reviews of payer audit determinations, identifying improper denials, and preparing detailed appeals that support the validity of charges and medical necessity of services rendered. Utilizing strong clinical judgment, in-depth knowledge of payer policies, and regulatory compliance standards, the RN Nurse Auditor advocates for appropriate reimbursement and contributes to the financial health of the organization. Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type Regular Cost Center CC005031 SYS - Revenue Cycle Middleware Pay Rate Type Salary Pay Grade Health-28 Scheduled Weekly Hours 40 Work Shift Job Description The RN Nurse Auditor is a key member of the Clinical Appeals team and reports directly to the Clinical...