RN Clinical Denials Appeals Specialist

CommonSpirit Health - Englewood, CO

Job Title: RN Clinical Denials Appeals Specialist

Position:

Job Type: Full Time

Pay: $35.17 - $56.10 / hour

Shift: Monday-Friday, 8am-5pm MST

Work Type: Remote

Location

Address:

City: Englewood

State: CO

ZIP Code:

Job Responsibilities

Function as a revenue management liaison for all care sites with external third-party payers to appeal denied claims.
Retrospectively identify appeals determination through research and coordination of completion of medical records and utilization review processes.
Identify areas for documentation and/or process improvement.
Promote proactive documentation compliance for reimbursement.
Demonstrate ability to adapt to ongoing changes within the health insurance industry.
Communicate and collaborate with other departments.
Maintain an active presence in inpatient and outpatient settings.

Required Skills

Core Skills

Clinical Denials experience
Utilization Review

Preferred Skills

Not specified

Requirements

Experience: 4 years clinical experience as a Registered Nurse; 3 years with progressive experience in Utilization Review preferred; prior experience writing clinical denial appeal letters required.

Education: BSN required

License & Certification:

Current RN License in the State of employment

Schedule:

Not specified

COVID-19 Requirements: Not Specified

Benefits

Several Medical, Dental, & Vision options
Spending Accounts including a Dependent Care FSA that can include an employer contribution
Retirement account options with a generous employer match
Tuition Reimbursement
Student Loan Forgiveness

Supplemental Pay

Not specified

Special Notes

Must have Clinical Denials experience clearly written out in your resume.

Facility Details

Name: CommonSpirit Health

Description: CommonSpirit Health Mountain Region is committed to building healthier communities and advocating for the poor and vulnerable, with high standards of care.

Specialties: