UR/TOC & Denials RN

Responsibilities Clinical Analysis, Data Management, and Denial Prevention Compile appropriate appeal responses to commercial and/or government payers regarding denial and/or audit, including follow‑up of appeals throughout the process for resolution and reporting Utilization Review, Utilization Management, Advocacy and Education Review concurrent denial/reimbursement from commercial and/or government payers for inpatient and outpatient services Qualifications Bachelor of Science in Nursing (BSN) or Masters of Science in Nursing (MSN) preferred; Associate degree in Nursing (ADN) required. Minimum of three years of experience in an acute care patient setting. Minimum of one year of Clinical Documentation or Appeal/Denial Management experience preferred. Utilization Review or Case Management experience preferred. Licensure, Certification, and Registration Current OK RN license required. Basic Life Support (BLS) training or retraining required and must be maintained for the duration of employment. Compensation and Benefits $30.10–$49.17/hr depending on previous work experience. 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. Work Shift Day Position Type Regular Full Time #J-18808-Ljbffr Norman Regional Health System