HEDIS Review Nurse Job in Elkridge 21075, Maryland Us
Position Description: Conduct hospital bill audits to validate the charges billed by hospitals to commercial customers. Performs onsite audits of charts comparing medical records to billed charges. Identify any discrepancies between the submitted hospital bill and the medical records. Maintain good working relationships with hospital auditors and associated hospital personnel.Schedule hospital audit Conduct audit, comparing itemized hospital bill to the medical records, identifying over charges, under charges and disallowed charges. Obtain hospital sign-off of completed audit Prepare completed audit files. This includes preparation of final audit summary sheet, discrepancy and disallowed sheets and other audit result documentation. Function as a member of a self-directed team to meet specific individual metrics.Partner with all functional components of the hospital audit team.Ability to communicate in writing and verbally.Ensure consistent application of the audit criteria.Document audit results, findings, actions, and outcomes in accordance with established guidelines.
Required Skills:
AUDITING, HEDIS, RN OR LPN REQUIRED
Join Aerotek Scientific®LLC, one of the fastest growing providers of scientific and clinical research services in the nation. Due to our growth, we're constantly on the lookout for qualified professionals to place in contract, contract-to-hire, and permanent placement positions across the scientific and clinical research communities. At Aerotek Scientific, we know it's more than just your day-to-day responsibilities that can make or break a job. It's the support you get. That's the reason Aerotek Scientific offers a variety of benefits including medical, dental, optical, 401k, and many more. Don't put your career in the hands of just anyone, put it in the hands of a specialist. Join the Aerotek Scientific team! Allegis Group and its subsidiaries are equal opportunity employers and will consider all applications without regard to race, marital status, sex, age, color, religion, national origin, veteran status, disability or any other characteristic protected by law.