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RN-RDC Coordinator
3 months ago
Find out for yourself why Southcoast Health has been voted 'Best Place to Work' for 6 years in a row
Join Southcoast Health, where your future is as promising as the care we provide. Our commitment to each other, our patients, and our community is more than a mission - it's our way of life, and you'll be at the heart of it.
Southcoast Health is a not-for-profit, charitable, health system with multiple hospitals, clinics and facilities throughout Southeastern Massachusetts and Rhode Island.
Nestled in local communities, Southcoast Health provides inclusive, ethical workplaces where our highly skilled caregivers offer world-class, comprehensive healthcare close to home.
We are searching for a talented RN-RDC Coordinator
A career at Southcoast Health offers you:
- A culture of well-being that embraces, respects, and celebrates the rich diversity of one another and the communities we serve
- Competitive pay and comprehensive benefits package
- Generous Earned Time Off Package**
- Employee Wellbeing Program
- 403B Retirement Plan with company match
- Tuition assistance / Federal Loan Forgiveness programs
- Professional growth opportunities and customized leadership training
Southcoast Health is an Equal Opportunity Employer.
Responsibilities
Under general supervision of Team Leader, Revenue Data Center, perform diversified duties relative to the appeals process of denials by third party payers. Complete appeal responses for all levels of denials for medical care and services rendered utilizing third party payers and organizations standards in the appeal process. Review post discharge appeals process identifying potential risk issues to the organization. Update database with response to appeals by payer, recuperated amounts and/or lost dollars. Work collaboratively with the Billing, Medical Records, Patient Registration Finance Physicians department and other multidisciplinary teams both within and outside the organization to improve reimbursement through effective utilization and monitoring of health care resources. Must be available to work as needed including extended hours and weekends.
Qualifications
- A Bachelors Degree in Nursing or other health care field or the equivalent knowledge and experience is required.
- Current Massachusetts RN license is required.
- Certification in Case Management preferred.
- Over five years up to and including seven years of related experience is required.
- One year of case management experience is preferred.
- Skills required are creative problem solving, critical thinking, proficient time management and organizational planning all applied to a strong clinical knowledge base.
- Must possess multitask skills and the ability to tolerate interruptions and a demanding work assignment. Knowledge of funding, resources, services, clinical standards and outcomes is crucial to the role.
- Must be fully vaccinated against seasonal Influenza and the COVID 19 virus or to be exempt from the requirement for medical or personal reasons by signing a statement certifying you are choosing to be exempt from vaccination once hired.
Pay Range
USD $85,592.00 - USD $149,011.20 /Yr.
