UR/TOC & Denials RN
$30.1 - $49.17 per hourNorman Regional Health
Clinical Analysis And Denial Prevention Specialist
Clinical Analysis, Data Management and Denial prevention
Responsible for compiling an appropriate appeal response to commercial and/or government payer regarding denial and/or audit, including follow up of appeals throughout process for resolution and reporting.
Utilization Review, Utilization Management, Advocacy and Education
Responsible for review of concurrent denial/reimbursement from commercial and/or government payers for inpatient and outpatient.
Qualifications
Education
- Bachelor of Science in Nursing (BSN) or Masters of Science in Nursing (MSN) preferred, Associate degree of Nursing (A.D.N.) required.
Experience
- 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.
- 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
- $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
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