RN Revenue Integrity

2 weeks ago

Miamisburg, United States Kettering Health Full time

Overview:

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether its by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

Campus Overview:

Kettering Health Miamisburg

  • Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
  • Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
  • The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care.
  • Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning.
  • 142 bed facility
  • Awarded with 100 Top Hospital by IBM Watson Health for the 10th time in 2019.
  • In 2020, KH Miamisburg received an A from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
  • Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
  • KH Miamisburg received several awards from Healthgrades:
    • Outstanding Patient Experience Award (2017-2019)
    • Americas 100 Best Hospitals for Prostate Surgery Award (2020)
    • Joint Replacement Excellence Award (2020)
Responsibilities & Requirements:

Responsibilities

  • Work under the direction/supervision of the Manager
  • Be responsible for analyzing revenue cycle deficiencies in order to prevent billing and regulatory claim edits, claim denials and other related charge capture obstacles by working collaboratively with Patient Access, Case Management, Contract Management, Medical Records and other Kettering Health Network departments
  • Work closely and collaboratively with Patient Financial Services Commercial and Medicare/Medicaid billing teams for prompt resolution of claim delay issues in compliance with Federal guidelines
  • Work to maximize revenue potential through the auditing of ALL Observation status accounts (including Observation-to-Inpatient status)
  • Preparation of and participation in Defensive Audits with outside auditing agencies
  • auditing of ALL Trauma admissions accounts, the auditing of specialized accounts, such as Blood Transfusion edits and the investigation and resolution of individual account audit requests, including ADR (Additional Development Request) audit requests from CMS and Hydration services denials from all payers
  • The RN Revenue Cycle Coordinator acts as Patient Financial Services liaison to share audit findings and identify ways to reduce/eliminate revenue cycle barriers through process improvements and to educate ancillary departments on recommended changes and processes

Requirements

  • RN degree from an accredited school of professional nursing and licensed to practice in the State of Ohio.
  • RN with minimum of 5 years clinical nursing experience
  • Strong understanding of the Revenue Cycle Registration, Medical Records, Billing practices and Compliance issues
  • Strong understanding of medical necessity guidelines
  • Experience with computers required. Must be able to utilize and navigate the electronic medical record with accuracy and independence
  • Ability to demonstrate initiative and good judgment in a self-directed role
  • Ability to clearly communicate with and establish and maintain good rapport with physicians, hospital administration, nurses and other healthcare team members


Preferred Qualifications:
  • BS/BSN from an accredited school preferred.
  • Experience with and/or knowledge of managed care contract terms and federal payer guidelines preferred.
  • Experience with hospital billing (UB92 form) and coding requirements/guidelines preferred.
  • Knowledge of federal, state, industry-wide utilization and billing regulations preferred.

  • RN Revenue Integrity

    5 days ago

    Miamisburg, United States Kettering Medical Center Network Full time

    Overview Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training...

  • Charge Registered Nurse

    4 weeks ago

    Miamisburg, United States PAM Health Full time

    Job DescriptionJob DescriptionCharge Registered Nurse (RN) 13 Week Internal Assignment - ICU experience HIGHLY preferredDon't need the benefits but want to stay local?! Check out this position at $65 per hour!(No Travel Reimbursement)Patient satisfaction is our ultimate goal and YOU make it possible. To fill this role, you’ll need: RN License in the...

  • Case Manager

    1 month ago

    Miamisburg, United States PAM Health Full time

    Job DescriptionJob DescriptionCase ManagerThe Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level team to facilitate...

  • Case Manager

    3 weeks ago

    Miamisburg, United States PAM Health Full time

    Case Manager The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level team to facilitate achievement of desired financial and...

  • Marketing Consultant

    10 hours ago

    Miamisburg, United States Sinclair Broadcast Group Full time

    POSITION SUMMARY WKEF-TV in Dayton, Ohio is looking for a marketing specialist and dedicated sales professional responsible for driving growth of assigned accounts, uncovering new opportunities, nurturing strong relationships with existing clients, and establishing a network to support overall account growth. Marketing Consultants are also expected to...

  • Licensed Vocational Nurse

    1 week ago

    Miamisburg, United States PAM Health Full time

    Licensed Vocational Nurse (LVN/LPN) The Licensed Vocational Nurse is responsible for providing appropriate nursing care, as directed by an RN on the nursing unit. Functions include gathering and reporting data, carrying out orders, and performing therapeutic procedures on patients in an age and population-appropriate manner, consistent with the policies,...

  • Licensed Practical Nurse

    1 week ago

    Miamisburg, United States PAM Health Full time

    Licensed Practical Nurse The Licensed Practical Nurse is responsible for providing appropriate nursing care, as directed by an RN on the nursing unit. Functions include gathering and reporting data, carrying out orders, and performing therapeutic procedures on patients in an age and population-appropriate manner, consistent with the policies, procedures and...

  • Marketing Consultant

    2 days ago

    Miamisburg, Ohio, United States Sinclair Broadcast Group Full time

    POSITION SUMMARYWKEF-TV in Dayton, Ohio is looking for a marketing specialist and dedicated sales professional responsible for driving growth of assigned accounts, uncovering new opportunities, nurturing strong relationships with existing clients, and establishing a network to support overall account growth. Marketing Consultants are also expected to learn...

  • Registered Nurse

    1 month ago

    Miamisburg, United States PAM Health Full time

    Job DescriptionJob DescriptionWound Care RNPRN - Weekends The Wound Care Registered Nurse is responsible for coordinating wound care therapy into the total nursing care plan for patients; participating in patient and family teaching and provides leadership by working cooperatively with ancillary nursing and other patient team personnel to maintain standards...

  • Charge Nurse

    3 hours ago

    Miamisburg, United States PAM Health Full time

    Job DescriptionJob DescriptionCharge - Registered NurseUnder the direction of the Chief Nursing Officer/Director of Nursing, Nurse Manager or Charge Nurse, the Registered Nurse is responsible for utilizing the nursing process while delivering, directing and supervising care to patients admitted to the nursing unit. The Registered Nurse plans, coordinates,...

  • Registered Nurse

    1 month ago

    Miamisburg, United States PAM Health Full time

    Job DescriptionJob DescriptionRegistered NurseIf you’re looking for a schedule that fits your lifestyle, check out PAM Health Specialty Hospital of Dayton and ask us about our new rates and comprehensive benefits package! We are a 44 bed LONG TERM ACUTE hospital seeking a Registered Nurse to join our PAMily. Registered Nurse responsibilities:Deliver,...

  • Rehabilitation Technician

    1 month ago

    Miamisburg, United States PAM Health Full time

    Rehabilitation Technician Under the direct supervision of a Therapist or Therapy Assistant, the Rehabilitation Technician will be responsible for participating in patient activities. The Rehabilitation Technician must be flexible to meet the needs of the department and provide clerical backup as needed to the department. Performs other related duties as...

  • Clinical/Hospital Liaison

    2 weeks ago

    Miamisburg, United States PAM Health Full time

    Clinical Navigator Ever heard of a clinical liaison? If you have healthcare sales experience, this could be the position for you! The Navigator cultivates referral relationships, manages assigned territory, and completes patient assessments. Makes sales contacts as well as analysis of referral and admission data from assigned territory. Works collaboratively...

  • Chief Nursing Officer | Miamisburg Rehab

    1 month ago

    Miamisburg, United States PAM Health Full time

    Job DescriptionJob DescriptionChief Nursing OfficerThe Chief Nursing Officer is responsible for ensuring the safety of the nursing unit(s). Directs all nursing service activities for the facility assigned by making recommendations for staff/patient ratios, by maintaining a system to determine and provide adequate staff for provision of appropriate nursing...