Licensed practical nurse jobs in Columbia, SC

About the role

Prepares for and performs institutional audits to assess appropriate provider billing and to identify any aberrant billings that may have an impact on reimbursement. Responsible for reviewing all aspects of claim processing to include fraudulent billing practices and to respond to providers on review/audit findings. Responsible for documenting cost savings related to reviews/audits. Identifies changes with hospital. This position is not eligible for sponsorship now or in the future.

What you'll bring

• Required Education: Associate's in a job related field
• Degree Equivalency: RN licensure or LPN licensure with additional one year of clinical nursing experience (the additional experience cannot be included in the required work experience).
• Required Work Experience: 3 years of clinical nursing and/or medical audit/investigations experience to include 2 years of medical/surgical bedside experience.
• Required Licenses and Certificates: Active, unrestricted RN or LPN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN or LPN license as defined by the Nurse Licensure Compact (NLC).
• Preferred Skills and Abilities: Knowledge of hospital and physician audit principles, procedures, and reimbursement.
• Preferred Software and Tools: Working knowledge of Microsoft Office, especially Word, Excel and Access

Benefits

Locations