What are the responsibilities and job description for the Nurse Auditor, Denials *Remote position at Providence Health?
Description
Providence St. Joseph Health is calling a Nurse Auditor to work remotely within our footprint states: AK, CA, MT, OR, TX and/or WA.
The Nurse Auditor is responsible for performing medical necessity reviews of denied claims and constructing appropriate appeal verbiage for submission to insurance companies. This review includes assessment of clinical documentation, utilization of supporting evidence and application of appropriate language to facilitate appeals. The incumbent would work closely with the clinical denials team.
Providence caregivers are not simply valued – they’re invaluable. Join our team at Revenue Cycle Business Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
- Upon hire: Oregon Registered Nurse License Or
- Upon hire: National Registered Nurse Compact License
- 2 years Clinical experience in acute care.
Preferred Qualifications:
- Multiple clinical and financial experiences.
Salary Range:
NorCal (Napa, Sonoma)
Min: $46.11, Max: $74.41
Southern California, NorCal (Humboldt) Alaska (Kodiak, Seward, Valdez)
Min: $41.09, Max: $66.32
WA Puget Sound Oregon (Portland) Alaska (Anchorage)
Min: $39.42, Max: $63.63
Oregon (Hood River, Medford, Seaside)
Min: $36.75, Max: $59.31
Eastern Washington (Richland, Spokane, Walla Walla)
Min: $35.08, Max: $56.62
Montana
Min:$31.74, Max: $51.22
Texas
Min:$23.07, Max: $48.53
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.
We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.
We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.
Requsition ID: 239164
Company: Providence Jobs
Job Category: Nursing-Patient Facing
Job Function: Nursing
Job Schedule: Full time
Job Shift: Day
Career Track: Nursing
Department: 4001 SS RC COMMER DENIALS
Address: OR Portland 4400 NE Halsey St
Work Location: Providence Office Park Portland Bldg 1-Portland
Pay Range: $See posting - $See posting
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Salary : $74
