Registered Nurse (RN) - Denial/UR

Norman Regional Health System•Norman, OK

8d•$29 - $47

About The Position

Clinical Analysis, Data Management and Denial prevention Responsible for compiling an appropriate appeal response to commercial and/or government 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.

Requirements

Bachelor of Science in Nursing (BSN) or Masters of Science in Nursing (MSN) preferred, Associate degree of Nursing (A.D.N.) required.
Minimum of three years of experience in acute care patient setting.
Current OK RN license required.
Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment.

Nice To Haves

Minimum of one year experience in Clinical Documentation or Appeal/Denial Management experience preferred.
Utilization Review or Case Management experience preferred.

Responsibilities

Clinical Analysis
Data Management
Denial prevention
Compiling appeal responses to commercial and/or government payers regarding denial and/or audit
Follow up of appeals throughout process for resolution and reporting
Utilization Review
Utilization Management
Advocacy
Education
Review of concurrent denial/reimbursement from commercial and/or government payers for inpatient and outpatient