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Denial RN, Business Office, Full-time, Days

Company: UT Health East Texas
Location: Tyler
Posted on: September 14, 2021

Job Description:

Advancing Healthcare Together – The Future of Healthcare is in East Texas Why UT Health - East Texas? Our People. Our people truly are our greatest strength. They make a massive difference in the amazing care we provide every day. We work closely together to create a positive experience for our patients and each other. Our Purpose. We will build on your experience and provide meaningful and purposeful career growth for your future. You will have the opportunity every day to make a difference in someone’s life and change the course of healthcare. Our Place. Tyler, TX is a small town with a huge heart where you will have the privilege of caring for your neighbors. Everybody is somebody here. Representing the very best in healthcare, UT Health East Texas is comprised of 10 hospitals and more than 50 clinics across east Texas. With nearly 7,500 employees and over 1,000 licensed in-patient beds, UT Health East Texas provides healthcare services to thousands of patients annually through our hospitals, clinics, Level 1 trauma facility, air emergency fleet and EMS service in a metropolitan service area of a quarter-million people. 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 denial 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. QUALIFICATIONS / REQUIREMENTS: Education: Bachelor of Science in Nursing (BSN) from an accredited school. Experience: Prefer 2 years of nursing experience in an acute care setting. Position requires fluency in English language to function in job environment appropriately. Good interpersonal, communication, team-work, and customer service skills. Good organizational, problem-solving and follow-through skills. Ability to multi-task constantly, react to changes quickly/productively, and tolerate interruptions. Ability to perform work when no directions are given, and give directions to others. Remain flexible, organized, professional and able to analyze, make sound decisions under stressful or crisis situations. Demonstrate knowledge of current computer systems, equipment or programs used in the organization. Demonstrate maturity and accountability. Certification and Licensure: Completion of education to obtain Licensure as a Registered Nurse (RN). BEHAVIORAL STANDARDS: Service -Patient Centered Customer Service: Genuinely care about people. -Cultivate a compassionate environment: Changing lives for the better together. Quality -Clinical and Operational Excellence: A relentless drive to be the best. -Holistic Approach: Think and act for the benefit of the whole. People -Promote a collaborative environment: Build effective working relationships with others. -Identify and Develop Talent: Prepare others to deliver excellence. Financial -Business Acumen: Know, own and drive our business. -Continually Simplify and Improve: Work to make everything as efficient as possible. Growth -Foster Innovation: Seek and apply leading edge solutions. -Set Clear Direction: Tell others where you are going, how to get there and why. PHYSICAL REQUIREMENTS: Must be able to lift at least 50 lbs, position patients and possess physical strength sufficient to assist in lifting/transferring patients and moving departmental equipment. Must possess digital dexterity. Must have keen sense of touch, smell, vision, and hearing. Must be able to stand and walk for long periods of time. ENVIRONMENTAL CONDITIONS: Exposure to communicable diseases and biohazardous materials, danger of infection from contaminated materials, falls on slippery floors; possibility of injury from moving heavy equipment or patients. OSHA category I position. Body substance isolation must be practiced.

Keywords: UT Health East Texas, Tyler , Denial RN, Business Office, Full-time, Days, Other , Tyler, Texas

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