Denials Management Nurse
Denials Management Nurse
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1 Vacancy
Job Description
Overview
As a RN Denials Management RNat CHI St Vincent youll oversee a department of care coordination team supporting our patients and families. Your previous experience in bedside and acute care adds tremendous value to our nursing team.
CHI St. Vincent a regional health network serving Arkansas is part of CommonSpirit Health. We have served Arkansas since 1888 with a history of many firsts. Together with more than 4500 coworkers 1000 medical staff and 500 volunteers we consistently receive praise for care advancements. CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health in 2019. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. CHI St. Vincent provides you with the same level of care you provide to others. We care about our employee well-being and offer benefits that complement and support your work/life offer the following benefits to support you and your family:Free Premium Membership to our program to help employees with child care pet care senior caregivers housekeepers & Insurance Flexible spending accounts Voluntary Protection: Group Accident Critical Illness and Identity Theft Adoption Assistance Employee Assistance Program (EAP) for you and your family Paid Time Off (PTO) Tuition Assistance for career growth and development Matching 401(k) and 457(b) Retirement Programs Wellness Programs.
If you are committed to social justice health equity and prepared to deliver care in new innovative ways you belong with us.
Responsibilities
The Denials RN is responsible and accountable for receiving processing and documenting all concurrent denials for assigned facilities.
The RN has an integral role within the revenue cycle by providing clinical expertise in the denials management process.
The Denials RN performs a root cause analysis of the concurrent denial formulates and implements a plan for addressing the specific root cause for that denial identifies gaps in processes that lead to concurrent denials documents and communicates findings to management.
Recommends and provides education in collaboration with their manager.
The Denials RN follows a standardized approach to managing denials in order to achieve the organizational objectives of financial stewardship and patient advocacy through accurate billing.
Incumbents will use professional judgment independent analysis and critical-thinking skills to apply clinical guidelines policies and payer knowledge to ensure the best possible financial outcome.
The Denials RN is accountable for demonstrating a strong commitment to promoting quality every day by demonstrating our organizational values of: Compassion Inclusion Integrity Excellence and Collaboration.
Qualifications
Unencumbered license to practice in the State of Arkansas
Bachelors Of Nursing Or related healthcare field
Minimum three (3) years clinical experience as Registered Nurse (RN)
5 years of RN experience
Preferred
Denials management experience
Previous case management utilization management or discharge planning experience strongly preferred
Care Management certification (CCM or ACM) or UM Certification
While youre busy impacting the healthcare industry well take care of you with benefits that include health/dental/vision FSA matching retirement plans paid vacation adoption assistance and more!
Employment Type
Unclear
