Denials Management Registered Nurse (RN)
Community Health Network • Indianapolis, IN5d • Remote
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Denials Management Registered Nurse (RN)
Community Health Network•Indianapolis, IN
•Remote
About The Position
Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, “community” is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered — and we couldn’t do it without you. Make a Difference The primary role of the Denial Management Registered Nurse is to research, analyze, document and appeal third party payer denials involving medical necessity or clinical issues. The Denial Management RN will work from home after orientation completion, and is required to maintain productivity requirements set by leadership.
Requirements
- 5 years of clinical experience required.
- Licensed as a Registered Nurse by the Indiana Professional Licensing Agency required.
- Associates or Bachelor of Science in Nursing is required.
- Graduate of National League for Nursing or Commission on Collegiate Nursing Education accredited school of nursing.
- A working knowledge of Utilization Management and Review.
- A working knowledge of Clinical and Patient Financial Documentation Systems.
- A working knowledge of Level of Care review.
- A working knowledge of Payer Appeals guidelines.
- A working knowledge of Regulatory guidelines.
- A working knowledge of Transitional Care.
Nice To Haves
- 1-3 years Case management preferred.
- 1-3 years experience with Third party payer (Medicare) preferred.
- Previous Denials experience highly preferred.
- Knowledge of Epic operating system preferred.
Responsibilities
- Research third party payer denials involving medical necessity or clinical issues.
- Analyze third party payer denials involving medical necessity or clinical issues.
- Document third party payer denials involving medical necessity or clinical issues.
- Appeal third party payer denials involving medical necessity or clinical issues.
- Work from home after orientation completion.
- Maintain productivity requirements set by leadership.
Benefits
- State-of-the-art technology
- Volunteer opportunities
- Benefits initiatives
- Learn and grow opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
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