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RN Registered Nurse - Clinical Denial Analyst

Company: AMITA Health
Location: Des Plaines
Posted on: January 15, 2022

Job Description:

We Are Hiring:AMITA Health is searching for an RN Clinicial Denial Analyst to join our growing team! Hours are Monday-Friday 8am-5pm, no weekends, no holidays. Remote position. Five years of experience required.
Our compassionate, talented team members are the real source of our strength. This is why we invest so heavily in their well-being. Offering robust education and training resources, as well as innovative practice groups and networks, we make it easier to deliver compassionate, quality care, and achieve success.
We Offer You:

  • Competitive wages
  • Affordable medical and dental
  • Retirement match
  • PTO and paid holidays
  • Significant professional opportunities
  • Innovative practice groups and networks
  • Comprehensive training
  • And so much more!What You Will Do:Serve as the central point person for all commercial and government claim recovery activities
    providing efficient management of work flow related to commercial denial/appeal and recovery audit
    • Use clinical and coding knowledge to ensure accurate and compliant charge items and to recognize and
      resolve billing inconsistencies.
    • Review commercial and government claim denials and audit requests and coordinates attempts to overturn
      denials by drafting appeals, negotiating with payers, or following up with payer utilization review
      departments in attempts of obtaining authorizations and claim payment.
    • Establishe and maintain positive and cooperative relationships with medical staff and care
      coordination leaders to ensure ongoing compliance with utilization review guidelines.
    • Collaborate with managed care department to code billable items for reimbursement.
    • Collaborate with appropriate staff to secure information for billable items.
    • Analyze and create reports to capture payer denial trends and volume, to support patient financial
      services and clinical leaders in the revenue cycle.
    • Coordinate projects and audits to improve processes related to revenue cycle, efficiency of charging
      and billing, and collection efforts.
    • May educate case management staff and other departments regarding payer changes and denial/appeal
      process.What You Will Need:Licensure / Certification / Registration:
      • Registered Nurse credentialed from the Illinois Board of Nursing obtained prior to hire date or job
        transfer date required.Education:
        • Diploma from an accredited school/college of nursing required.Additional Preferences:No additional preferences.Why Join Our Team:AMITA Health, one of the largest health systems in Illinois, is comprised of 19 hospitals and more than 230 sites of care. With more than 900 providers in its medical groups, 26,000 associates and 7,000 physician partners, AMITA Health serves over 6.6 million residents in the greater Chicagoland area.

          We are committed to improving accessibility to healthcare in the communities we serve. We hold ourselves accountable to our patients and one another, and we work hard to treat the whole person, body, mind and spirit. Our compassionate, talented team members are the source of our strength, and we invest heavily in their well-being. We offer significant professional opportunities, career advancement potential, comprehensive training and competitive wages.Equal Opportunity Employer:AMITA Health will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.

          For further information regarding your EEO rights, click on the following link to the "EEO is the Law" poster:

          EEO is the Law Poster Supplement

          Please note that AMITA Health will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. AMITA Health will not solicit money or banking information from applicants.

Keywords: AMITA Health, Des Plaines , RN Registered Nurse - Clinical Denial Analyst, Healthcare , Des Plaines, Illinois

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