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Rn Denials Specialist Jobs

Company

Ensemble Health Partners
Address , Remote
Employment type FULL_TIME
Salary
Expires 2023-10-08
Posted at 9 months ago
Job Description
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference
The Opportunity:
The Clinical Denials Nurse is responsible for:
  • Using clinical decision making to determine the appropriate actions needed to recover or defend revenue
  • Identifying and reporting trends to remediate issues and assist with internal process improvement
  • Reviewing medical records against nationally recognized clinical criteria guidelines (Interqual, MCG, NCD/LCD,DCA, etc.)
  • Identifying the root cause for clinical claim denial
  • Writing professional appeals in response to denied claims or payer audit requests
Minimum Requirements:
  • Understanding of Revenue Cycle including admission, billing, payments and denials preferred
  • Case Management or Utilization Review experiences strongly preferred
  • Knowledge of patient insurance process and requirements preferred
  • Active RN or LPN license required
  • 2+ years of experience in an acute care hospital direct patient care setting required
#LI-REMOTE
Join an award-winning company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
  • Innovation
  • Work-Life Flexibility
  • Purpose + Values
  • Leadership
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
  • Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
  • Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
  • Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
  • Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact .
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