Memorial is a non-profit, city-owned, level II trauma center with 3 hospitals. Share the excitement of providing patient centered care at a top hospital system.
Memorial Health System, Colorado Springs CO Department: Contracts/Reimbursement (571) - Full-time Exempt - Monday-Friday - 8:00 a.m. - 5:00 p.m. Salary: Salary range begins at $49,691 Coordinates Medicare Recovery Audit Contractor (RAC), Medicare ZPIC (Zone Program Integrity Contractor), Medicaid Integrity Contractor (MIC), Medicare CERT (Comprehensive Error Rate Testing Program), Medicaid DRG Education program, and other government entity audit activities, ensures interdepartmental collaboration in the audit process, and proactively educates healthcare providers, coders, and other team members within the system to promote compliance with government issues and proper billing regulations. Performs clinical audits of charts for medical necessity, proper coding, and proper charging. Responsible for installation and ongoing maintenance of audit tracking software; inputs, tracks, and ensures all submission deadlines and appeal time frames are met, prepares appeals and collaborates with the proper physicians or other allied health personnel as necessary to prepare appeals. Minimum Education: Bachelor of Science in Nursing (BSN). Currently licensed to practice professional nursing in the State of Colorado.Minimum Experience: At least 2 years or more directly related experience reading and auditing medical records, appealing claims denials from a medical necessity standpoint, some experience with coding, charging and charge master, computer experience.