Revenue Cycle Nurse Coordinator

4 days ago

Coeur D'Alene, United States Kootenai Health Full time

Revenue Cycle Nurse Coordinator Job Code: 28277 Position SummaryResponsible for utilizing nationally recognized criteria sets and authoring clinical appeals to be submitted to appropriate payers in order to secure recovery of denied dollars. Responsibilities•Provides leadership with examples of trends which are communicated to the clinical department leadership for process improvement opportunities•Requires knowledge of regulatory compliance related to Medicare, Medicaid and commercial payers to ensure compliance with medical necessity and/or benefit determination•Support denial resolution across the organization, hospital and clinics•Utilizes clinical skills to assist in the facilitation of referrals, authorizations and financial clearance for clinical procedures and treatment regimens•Responsible to contact payer, provider and provider staff for assistance in rescheduling practices including medical information gathering, confirmation of medical necessity and urgency determinations•Prepares medical cases for payer peer to peer review•Assists with communication and training initiatives related to referral/pre-authorization performance improvement initiatives across Kootenai Health•Works collaboratively with internal and external stakeholders to assess workflow processes, identify insufficiencies, investigate root causes and work to implement change to ensure timely authorizations•Understands the business of the department and how the work impacts the overall revenue cycle•Recognizes out of the ordinary situations and works with stakeholders to improve processes•Performs other related duties as assigned•Familiar with standard concepts, practices, and procedures within the field•Relies on experience and judgment to plan and accomplish goals•Regular and predictable attendance is an essential job function•Competent to meet age specific needs of the unit assigned Requirements and Minimum Qualifications•BSN required, MSN preferred•State of Idaho Registered Nurse or licensure pending as documented by temporary licensure OR current RN licensure from a state participating in the "multistate privilege to practice" compact with Idaho•Minimum 3 years' clinical practice experience required•Prior experience with regulatory requirements for medical necessity for all payers preferred•Strong interpersonal skills and proven ability to function in a confidential and highly responsible manner•Excellent computer skills and ability to learn multiple electronic medical record systems, including use of Excel, Word and PowerPoint office products Working Conditions•Must be able to maintain a sitting position•Typical equipment used in an office job•Repetitive movements•Remote eligible About Kootenai Health Kootenai Health is a highly esteemed health care organization, serving patients throughout northern Idaho and the Inland Northwest. We pride ourselves on our outstanding reputation as both an employer and a health care provider. We have been recognized with many accolades and distinctions including being recognized as a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. As your next employer, we are excited to offer you: 100% employer-paid health insurance premiums for full-time employees. Part-time employees pay only a small portion a month for medical, dental, and vision coverage. Benefits start 1st of the month following 30 days of employmentA tuition assistance program available after 90 days. If you want to further your education, we'll help you pay for itKootenai Health will match your contributions in a defined contribution 457 retirement plan based on years of service ranging from 3-6 percent. Kootenai Health will contribute an amount equal to two percent of your gross earningsCompetitive salaries with night, weekend and PRN shift differentialsAn award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars and coaching Employees receive discounts at The Wellness Bar, PEAK Fitness, various cell phone carriers, and moreRobust and interactive employee bonus program, utilize our mobile ERIN app to alert employees to new positions, make referrals and track your bonusesAnd much more If you strive to be an integral part of a high-quality healthcare system like Kootenai Health, we want to meet you Apply today Please reach out to Lindsay Buchanan lbuchanan@kh.org with any questions. Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.

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