Note: The AHCA/NCAL LTC Career Center will cease operations on December 31, 2024. Please visit the AHCA/NCAL Careers in Caring website for additional long-term care employee recruiting information.
CommonSpirit Health Mountain Region is committed to building healthier communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen-both inside our hospitals and out in the community. With locations throughout Colorado, Utah, and Kansas, we deliver the same high standard of care to our employees as we do to our patients. Our 20 hospitals, emergency and urgent care centers, home care and hospice, Flight for Life Colorado TM , telehealth and over 240 physician practices and clinics offer endless opportunities! Here, you can grow your career and impact the people in the communities you serve.
CommonSpirit Health is one of the nation?s largest nonprofit, faith-based health systems, with a team of over 150,000 employees and 25,000 physicians and advanced practice clinicians. CommonSpirit operates more than 2,200 care sites and 140 hospitals, serving some of the most diverse communities across the nation, letting humankindness lead the way.
Overview:
You have a purpose, unique talents and NOW is the time to embrace it, live it and put it to work. We value incredible people with incredible skills - but your commitment to a greater cause is something we value even more.
The Denials RN is responsible and accountable for receiving, processing and documenting all concurrent denials for assigned facilities. The RN has an integral role within the revenue cycle by providing clinical expertise in the denials management process. The Denials RN performs a root cause analysis of the concurrent denial, formulates and implements a plan for addressing the specific root cause for that denial, identifies gaps in processes that lead to concurrent denials, documents and communicates findings to management. Recommends and provides education in collaboration with their manager. The Denials RN follows a standardized approach to managing denials in order to achieve the organizational objectives of financial stewardship and patient advocacy through accurate billing. Incumbents will use professional judgment, independent analysis and critical-thinking skills to apply clinical guidelines, policies, and payer knowledge to ensure the best possible financial outcome. The Denials RN is accountable for demonstrating a strong commitment to promoting quality every day by demonstrating our organizational values of: Compassion, Inclusion, Integrity, Excellence, and Collaboration.
Qualifications:
In addition to bringing your whole self to the workplace each day, qualified candidates will need the following:
Required: Minimum three (3)years clinical experience as Registered Nurse (RN) required.
Preferred: ? Graduate of an accredited school of nursing (Bachelor's Degree in Nursing (BSN)) or related healthcare field. ? 5 years of RN experience preferred. ? Minimum Three (3) years utilization management experience preferred ? Denials management experience preferred. ? Care Management certification (CCM or ACM) preferred
RN License
Preferred ? Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred
Physical Demand Level: Light
This role will work a schedule between 7:00am - 5:00pm and is remote in CO. You do have to have the ability to go to a CO facility for internet issues and meetings.
Your Connected Community:
At CommonSpirit Mountain Region, we believe in the healing power of humanity and serving the common good through our dedicated work and shared mission to celebrate humankindness.
CommonSpirit Mountain Region?s Corporate Service Center is headquartered in Centennial, CO where our corporate leaders and centralized teams support our hospitals, clinics and people - including marketing, human resources, employee benefits, finance, billing, talent acquisition/development, payor relations, IT, project management, community benefit and more. Many of our centralized teams offer a remote work option which supports a healthy work-life balance while still providing a culture of collaboration and community where incredible people are doing incredible things every day.
Our Total Reward Offerings:
Be sure to consider our generous benefits as part of your overall compensation! Designed with your well-being in mind, our benefits include:
Medical
Dental
Vision
401K with generous match
Daycare FSA that can include a company contribution