Responsibilities:
- Clinical Analysis, Data Management and Denial prevention
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Responsible for compiling an appropriate appeal response to commercial and/or government appeal response to commercial and/or government payer regarding denial and/or audit, including follow up of appeals throughout process for resolution and reporting.
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Utilization Review, Utilization Management, Advocacy and Education
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Responsible for review of concurrent denial/reimbursement from commercial and/or government payers for inpatient and outpatient.
Qualifications:
Education
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Bachelor of Science in Nursing (BSN) or Masters of Science in Nursing (MSN) preferred, Associate degree of Nursing (A.D.N.) required.
Experience
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Minimum of three years of experience in acute care patient setting.
- Minimum of one year experience in Clinical Documentation or Appeal/Denial Management experience preferred.
- Utilization Review or Case Management experience preferred.
Licensure/Certification/Registration/ETC.
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Current OK RN license required. Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment.
Compensation/Benefits
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$30.10-$49.17/hr depending on previous work experience.
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Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement.
