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11 months agotaleo

Denials Management Registered Nurse (RN) - Remote

Community Health Network / Hospitals and Health Care
Newsham, England, United Kingdom | RemoteRemote SolelyFull Time
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AI Summary

As a Denials Management Nurse, you will research, analyze, document and appeal third party payer denials involving medical necessity or clinical issues. This role requires a strong understanding of various clinical and regulatory guidelines.

Candidates must have 5 years of clinical experience and 1-3 years in case management, with a preference for experience with Medicare. A Bachelor of Science in Nursing and a valid RN license in Indiana are required.

Job Details
Job Type: FULL TIME
Visa Sponsorship: No
Work Arrangement: Remote Solely
Experience Level: 5 - 10 years
Hours: 40 hrs/week
Language: English
Key Skills
Clinical ExperienceCase ManagementThird Party PayerUtilization ManagementClinical DocumentationPatient Financial DocumentationLevel of Care ReviewPayer Appeals GuidelinesRegulatory GuidelinesTransitional Care
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Hiring Bonus for Qualified RN!

Join Community
Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, “community” is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered — and we couldn’t do it without you.

Make a Difference
As a Denials Management Nurse, you will research, analyze, document and appeal third party payer denials involving medical necessity or clinical issues.

Exceptional skills and qualifications

  • 5 years of clinical experience

  • 1-3 years Case management

  • 1-3 years experience with Third party payer (Medicare) preferred

  • A working knowledge of the following: Utilization Management and Review, Clinical
    and Patient Financial Documentation Systems, Level of Care review, criteria Payer Appeals guidelines, Regulatory
    guidelines,Transitional Care (Required)

 

License and Education

  • Graduate of National League for Nursing or Commission on Collegiate Nursing Education accredited school of nursing. Bachelor of Science in Nursing is required 
  • Licensed as a Registered Nurse by the Indiana Professional Licensing Agency required

     

    This is a REMOTE position. Community caregivers performing work remotely are permitted to live in the following states: Indiana, Illinois, Ohio, Michigan, Kentucky, Florida and Texas. Caregivers are not allowed to perform work remotely outside of the above states. Applicants from other states may apply; however, if hired, they will be required to relocate to one of the above states within 60 days of their employment date

About Community Health Network

Community Health Network is a non-profit health system in Central Indiana offering a comprehensive range of integrated services, emphasizing exceptional care and community connection.

Hospitals and Health Care
8,918 employees
Indianapolis, IN
Most staff in USA
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