HOSPITAL AUDIT NURSE-PFS ADMINISTRATION
Job Field: Office Jobs
Location: San Francisco, CA
Salary: $Not stated
JOB SUMMARY:
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<tr><td valign="top" width="450"><b>Title: Hospital Audit Nurse-PFS AdministrationLocation: California-San Francisco-San FranciscoOther Locations: California-San Francisco North Bay-Santa Rosa, California-North Coast-Crescent City, California-North Coast-Lakeport, California-San Francisco-San Francisco, California-San Francisco North Bay-NovatoThe Sutter West Bay Region supports our affiliated hospitals, medical foundations and private practices to function as one team - all working together as an integrated delivery system spanning from Lakeport to San Francisco, sharing best practices and delivering better value to our patients. Everything we do is driven by an unwavering commitment to caring for, and about, our patients.The region consists of four acute care medical centers, California Pacific Medical Center, Novato Community Hospital, Sutter Medical Center of Santa Rosa, Sutter Lakeside; and as of Jan. 1, 2010, one regional medical foundation, Sutter Pacific Medical Foundation. In 2008, our affiliates had 10,462 employees; 179 medical foundation providers and 307 affiliated IPA physicians; 134,706 active patients; 50,706 discharges; 9,841 births; and 171,973 emergency department visits.The Audit Nurse serves as the primary liaison between the Sutter West Bay hospitals and payors/patients in the coordination of the following activities:* Defense Audits - onsite medical record audits performed by third-party insurance payers for the purpose of charge accuracy and validation,* Customer Service Complaints* Patient Financial Services staff questions/departmental charge explanationsCalifornia licensed RN or LVN with a minimum of five years clinical experience. Full knowledge of clinical and ancillary processes required. Must be able to understand billing processes as well. Knowledge of compliance requirements by Federal payers would be an advantage.
KEY REQUIREMENTS:
Not stated