Denial RN, Business Office, Full-time, Days
Company: UT Health East Texas
Posted on: September 14, 2021
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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