Clinical Denial Appeals Registered Nurse / Patient Financial Services / Full-Time / Days
Company: Ardent Patient Financial Services (CBO)
Posted on: October 14, 2021
Clinical Denial Appeals Registered Nurse, Patient Financial
Services, Full-time, Days, Albuquerque, NM. We are looking for a
Clinical Denial Appeals RN to join our Patient Financial Services
team, in Albuquerque NM. This position is remote or office based.
This full-time job is located at Lovelace Central Business Offices
in Albuquerque: Organizational Position supports facilities for all
Lovelace, Hillcrest & University of Kansas hospitals. We are
dedicated to exceeding our customers’ expectations in every way.
Registered Nurse Clinical Denial Appeals Job Responsibilities: This
position is to assess and utilize clinical and financial
information to effectively appeal claim denials after service is
provided related to Level of Care, Medical Necessity & continued
authorization related to IP and OBS claims. Ability to effectively
write appeals with all required information needed to overturn
denials. Must be able to work flexible hours, at the ABQ office or
remotely. In partnership with patients, physicians, and other
health care providers, this position will support utilization of
resources and obtain appropriate & optimal reimbursement to assure
maximum appropriate reimbursement for the organization. Position
identifies trends and disseminates as necessary for appropriate
action All work processed by the incumbent is confidential.
Completes established competencies for the position within
designated introductory period. Other related duties as assigned.
Registered Nurse Clinical Denial Appeals Education and Experience
Job Requirements: Minimum: Associate’s Degree or Diploma of Nursing
Desired: Bachelor’s Degree in Nursing 5 years clinical nursing
experience and two years managed care experience. Knowledge of the
operations of patient billing; the UB -04, the Itemized Statement,
coding information reported on claim and grievance procedures.
Demonstrated knowledge of the State Medicaid structure and other
insurance plans (i.e., commercial, Medicare, HMO/PPOs, etc.) Valid
NM Nursing license or NM compact license (within 90 days of hire)
BLS; HIRING DEPARTMENT MAY ALSO REQUIRE ACLS and or PALS. Why
Lovelace? Named one of the 150 Great Places to Workin Healthcare by
Becker's Hospital Review Named one of the Best Places to Work by
Albuquerque Business First Named Top Workplace by Albuquerque
Journal ,2013, 2014, and 2015 Named to Modern Healthcare's 100 Best
Places to Workfive times since2008 Lovelace is a drug-free employer
with smoke free campuses.
Keywords: Ardent Patient Financial Services (CBO), Albuquerque , Clinical Denial Appeals Registered Nurse / Patient Financial Services / Full-Time / Days, Other , Albuquerque, New Mexico
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