Description
Position at Northern Dutchess Hospital
Summary:
Coordinates inpatient denials for the hospital with emphasis on data management and reporting. Coordinates and manages all Utilization Review activities and works collaboratively with a multidisciplinary approach with other departments in an effort towards meeting financial goals and continued accountability. Coordinates department operations and serves as front line liaison for department.
Responsibilities:
- Coordinates inpatient denials for the hospital.
- Organizes utilization review activities.
- Coordinates workflow within the department and throughout the network.
- Liaises with other Revenue Center departments for problematic denials.
- Coordinates UR reimbursement in an accurate and timely manner.
- Works proactively with the Commercial payers to escalate denials with specific system-limited and time sensitive issues.
- Assists in timely sorting and disseminating requests for medical information from insurers and other sources to the case managers and physician advisor.
- Obtains Medicaid & Managed Medicaid Authorization for patient transportation.
- Edits and approves PI payroll.
- Manages department calendars.
- Tracks and monitors department expenditures and reconciles expenses and vouchers.
- Maintains and Models Nuvance Health Values.
- Demonstrates regular reliable and predictable attendance.
- Performs other duties as required.
Education Skills Experience
- High School diploma
- 2 years clerical/computer experience required
- Knowledge of insurance protocols preferred
- Knowledge of medical terminology
- Excellent organizational verbal and written communication skills
License Registration or Certification Requirements:
Working Conditions:
Manual: significant manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Northern Dutchess Hospital
Org Unit: 1157
Department: Care Coordination
Exempt: No
Salary Range: $20.86 - $38.73 Hourly
Required Experience:
IC
DescriptionPosition at Northern Dutchess HospitalSummary:Coordinates inpatient denials for the hospital with emphasis on data management and reporting. Coordinates and manages all Utilization Review activities and works collaboratively with a multidisciplinary approach with other departments in an e...
Description
Position at Northern Dutchess Hospital
Summary:
Coordinates inpatient denials for the hospital with emphasis on data management and reporting. Coordinates and manages all Utilization Review activities and works collaboratively with a multidisciplinary approach with other departments in an effort towards meeting financial goals and continued accountability. Coordinates department operations and serves as front line liaison for department.
Responsibilities:
- Coordinates inpatient denials for the hospital.
- Organizes utilization review activities.
- Coordinates workflow within the department and throughout the network.
- Liaises with other Revenue Center departments for problematic denials.
- Coordinates UR reimbursement in an accurate and timely manner.
- Works proactively with the Commercial payers to escalate denials with specific system-limited and time sensitive issues.
- Assists in timely sorting and disseminating requests for medical information from insurers and other sources to the case managers and physician advisor.
- Obtains Medicaid & Managed Medicaid Authorization for patient transportation.
- Edits and approves PI payroll.
- Manages department calendars.
- Tracks and monitors department expenditures and reconciles expenses and vouchers.
- Maintains and Models Nuvance Health Values.
- Demonstrates regular reliable and predictable attendance.
- Performs other duties as required.
Education Skills Experience
- High School diploma
- 2 years clerical/computer experience required
- Knowledge of insurance protocols preferred
- Knowledge of medical terminology
- Excellent organizational verbal and written communication skills
License Registration or Certification Requirements:
Working Conditions:
Manual: significant manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Northern Dutchess Hospital
Org Unit: 1157
Department: Care Coordination
Exempt: No
Salary Range: $20.86 - $38.73 Hourly
Required Experience:
IC
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