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Job Location:
Asheville, NC - USA
Yearly Salary:
$ 71557 - 147033
Posted on:
19 hours ago
Vacancies:
1 Vacancy
Job Summary
Summary
Join the Mid-Atlantic Consolidated Patient Accounts Center (MACPAC) located in Asheville NC. The CPAC is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by standardization and consolidation of functions and the integration of VHA and industry best standards.
Responsibilities of the RUR Registered Nurse include but are not limited to the following:
- Applies the nursing process to conduct clinical reviews for the purpose of pre-certification admission continued stay and discharge reviews to obtain approval from third party payers (TPP).
- Safeguards patient privacy and maintains confidentiality of all electronic and printed patient information according to HIPAA guidelines the Privacy Act and VHA policy.
- Conducts special eligibility reviews including Service Connection (SC) Agent Orange Combat Vet and other special authority (SA) eligibilities as per regulations for third party revenue encounters including Inpatient/Outpatient level of care RXs Care in the Community DME and Ambulance.
- Conducts clinical legal relatedness review for Regional Counsel TORT Claims No Fault and Workers Compensation cases to validate related care for reimbursement.
- Conducts clinical appeals as required by the third-party payers to overturn denials and increase reimbursement.
- Responds to customer service issues regarding SC/SA care and treatment to validate billing appropriateness.
- Educates VA medical facility providers and other staff on revenue related topics.
- Completes unit specific documentation based on CPAC RUR standards and policy.
- Utilizes comprehensive knowledge of nursing clinical practice and case management principles to assess appropriate level of care and to ensure compliance with established non-VA care authorizations and guidelines.
- Collaborates as needed for revenue cycle tasks with CPAC and VA medical facility staff including but not limited to Facility Revenue Billing Insurance Verification Veteran Services Compliance Providers Health Information Management (HIM) Utilization Management (UM) and Community Care.
- Completes 4-6 month orientation to meet the complexity of working 40 work drivers and documentation.
- Successfully completes Blackboard training (training designed to introduce staff to revenue operations and the staff role).
- Collaborates with third party payers on ordered level of care and treatment plans conducting reviews on Service Connection (SC) non-SC Special Authority (SA) precertification prospective review concurrent review denial management retrospective review admission and continued stay patients.
- Tracks revenue charges and recovered to maintain and reach facility goals.
- Reviews data analytics and metric expectations.
- Prioritize workload according to department need and leadership direction.
- The RUR RN participates on CPAC and/or facility committees workgroups performance improvement projects and/or huddle boards.
Pay: Competitive salary regular salary increases potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave 13 days of sick leave 11 paid Federal holidays per year)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory
Work Schedule: Monday-Friday 8:00am - 4:30pm (Schedule may vary based on facility need)
Telework: Not permitted.
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized.
Permanent Change of Station (PCS): Not Authorized.
Conditions of employment
- U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
- All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
- Selective Service Registration is required for males born after 12/31/1959.
- Subject to background/security investigation.
- Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements ( Effective May 7 2025 drivers licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
- Must pass pre-employment physical examination.
- Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
- You may be required to serve a probationary period.
- Complete all application requirements detailed in the Required Documents section of this announcement.
Qualifications
Basic Requirements:
- English Language Proficiency. In accordance with 38 U.S.C. 7403(f) no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
- Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a masters level bridge program in nursing who have completed coursework equivalent to a bachelors level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005 Appendix G6); OR In cases of graduates of foreign schools of professional nursing possession of a current full active and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD).
- Current full active and unrestricted registration as a graduate professional nurse in a State Territory or Commonwealth (i.e. Puerto Rico) of the United States or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements but do not possess the required licensure may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)
Grade Determinations: The following Scope Education and Dimension criteria must be met in determining the grade assignment of candidates and if appropriate the level within a grade. The Dimension requirements (Practice Veteran/Patient Driven Care Leadership Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: I Level I
Reference: For more information on this qualification standard please visit Requirements: This position requires visual acuity keen hearing clear distinctive speech and manual dexterity. This position requires potentially long periods of continued sitting and computer use and typing. The RUR nurse must be a mature flexible sensible individual capable of working effectively in stressful situations able to shift priorities based on organizational needs and solve problems independently while utilizing critical thinking skills. See VA Directive and Handbook 5019.
Education
There is no educational substitution at this grade level.
Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges universities schools or institutions may be used to qualify for Federal employment. You can verify your education here: If you are using foreign education to meet qualification requirements you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information visit:
Additional information
This job opportunity announcement may be used to fill additional vacancies.
This position is in the Excepted Service and does not confer competitive status.
VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38 and are not covered by the Schedule A excepted appointment authority.
If you are unable to apply online or need an alternate method to submit documents please reach out to the Agency Contact listed in this Job Opportunity Announcement.
Under the Fair Chance to Compete Act the Department of Veterans Affairs prohibits requesting an applicants criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process visit Human Resources and Administration/Operations Security and Preparedness (HRA/OSP) at The Fair Chance Act.
Candidates should be committed to improving the efficiency of the Federal government passionate about the ideals of our American republic and committed to upholding the rule of law and the United States Constitution.
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Eligibility for benefits depends on the type of position you hold and whether your position is full-time part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
Required Experience:
IC
Key Skills
- EMR Systems
- Hospital Experience
- Acute Care
- ICU Experience
- Dermal Fillers
- Experience Administering Injections
- Home Care
- Nursing
- Botox Experience
- Critical Care Experience
- Medication Administration
- Tube Feeding
