• Job Description

  Req#: 00553503
  Employer Industry: Healthcare
  
  Why consider this job opportunity:
  - Hourly pay range: $35.63 - $53.45
  - Opportunity for career advancement and growth within the organization
  - Supportive and collaborative work environment
  - Chance to make a positive impact on revenue optimization and denial management
  - Engage with a diverse and inclusive workforce committed to equitable care
  
  What to Expect (Job Responsibilities):
  - Coordinate denial management processes for the Revenue Integrity department, focusing on retrospective follow-up and appeal processing
  - Track denials and audits, identifying trends and collaborating with colleagues on education and reporting
  - Review utilization guidelines and identify solutions to reimbursement issues
  - Provide clinical information and support to intra and inter-departmental teams and payers
  - Maintain strong relationships with the Payer Strategy team to resolve clinical denials
  
  What is Required (Qualifications):
  - Registered Nurse and graduate of an accredited school of nursing with at least four (4) years of nursing experience, including two (2) years in utilization review/case management
  - Current registration with the State Board of Nursing Examiners or temporary permit to practice nursing
  - Demonstrated knowledge of revenue cycle and denial management functions
  - Knowledge of healthcare financing, managed care, and federal/state regulations
  - Excellent verbal and written communication and organizational abilities
  
  How to Stand Out (Preferred Qualifications):
  - Outpatient CDI experience
  - Working knowledge of Electronic Health Records (EHR)
  - Familiarity with third-party billing requirements and regulations
  - Experience in case management and utilization management
  - Bachelor's Degree in a related field
  
  #Healthcare #RevenueIntegrity #DenialManagement #CareerOpportunity #DiversityAndInclusion
  
  "We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer."

• About the company

  Trinity Health employs about 129,000 colleagues, including 7,500 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services — ranked by number of visits — in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.

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