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RN Recovery Nurse Specialist - Revenue Cycle Solutions Team - Full Time - Days - Work from Home
This job is now closed
Job Description
- Req#: REQ_00199768
Employer Industry: Healthcare Services
Why Consider this Job Opportunity:
- Salary up to $N/A
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and financial reimbursement
- Professional development opportunities
- Strong financial skills development
What to Expect (Job Responsibilities):
- Validates a specific level of care and evaluates against registered level of care to determine which medical necessity level of care is required
- Reviews all incoming denial and informational requests from regulatory and other agencies in respect to clinical medical necessity determinations
- Identifies, plans, and coordinates aspects of medical necessity reviews with others as necessary
- Maintains current knowledge of third party payer and government requirements related to job functions
- Adapts behavior to the specific patient population, including respecting privacy and adapting communication style
What is Required (Qualifications):
- Must have computer skills and dexterity required for data entry and retrieval of patient information
- Must be proficient with Windows-style applications, various software packages specific to role and keyboard
- Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process
- Current State of Louisiana Registered Nurse (RN) License
- Certification in Case Management (CCM) or Certified Professional in Utilization Review, Utilization Management or Health Care Management (CPUR, CPUM, and CPHM)
How to Stand Out (Preferred Qualifications):
- Experience in Appeal/Denial Management
- 3 years Hospital based experience in the delivery of patient care as an RN
- Experience functioning independently and working well within a team setting
- Experience responding to change positively and working calmly as well as efficiently in high pressure situations
- Associate's or Bachelor's degree in Nursing
#HealthcareServices #PatientCare #CareerOpportunity #ProfessionalDevelopment #NurseLife
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