Job Seekers, Welcome to IECA Career Center
CLINICAL APPEALS NURSE - PATIENT FINANCIAL SERVICES - FT DAYS
University of California Irvine (UCI)
CLINICAL APPEALS NURSE - PATIENT FINANCIAL SERVICES - FT DAYS
University of California Irvine (UCI)
 CLINICAL APPEALS NURSE - PATIENT FINANCIAL SERVICES - FT DAYS Updated: Jul 30, 2020 Location: Orange Job Type: Department: Patient Financial Services UC Title: Reimbursement HC Analyst 4 Position Number: 40324241 Reports to: Dir, Patient Financial Svcs Working Title: Reimbursement HC Analyst 4 Cost Center: Patient Financial Services (8550) Bargaining Unit: None FLSA: Exempt Job Code: 6768 Date Created: 11/04/2019 Shift: Day Shift Hours: 40.00 Position Summary: Incumbent is responsible for planning, directing and overseeing all aspects of Clinical Appeals and Charge Audits. The Clinical Appeal Nurse will be in charge of initiating the appeal process and developing victorious appeal letters to support medical necessity or level of care. Provides necessary training and education to staff involved in processes and ensures standards complies with federal, state and other regulatory agency rules and regulations. Works with Care Management leadership and Physician Advisors to ensure knowledge of denial to improve impactful areas. Actively participates on organizational performance improvement projects. Serves as a role model and resource to colleagues, staff and others. Salary Range: Rate Minimum $68,500.00 Maximum $140,200.00 Required Qualifications: 3 year experience with InterQual/MCG Guidelines required 3 years' working in an Acute Hospital Utilization Management, Concurrent Review Process or Care Management area Ability to establish and maintain effective working relationships across the HealthSystem Ability to maintain a work pace appropriate to the workload Bachelor of Science in Nursing Demonstrated ability to lead change and effectively manage conflict Excellent analytical skills Excellent working knowledge of desktop computer productivity tools Excellent written and verbal communication skills in English Experience generating victorious Appeal Letters Knowledge of CMS, DHCS, Joint Commission, CADP, and other regulatory and compliance requirements Must demonstrate customer service skills appropriate to the job Must possess the skill, knowledge and abilities essential to the successful performance of assigned duties Outstanding interpersonal skills; ability to interact effectively at all levels of the organization Proficiency in Microsoft Office suite Strong knowledge and understanding of ICD-10 and CPT codes Preferred Qualifications: Knowledge of University and Medical Center organizations, policies, procedures and forms Knowledge of patient safety strategies Knowledge of quality improvement methodologies Physical, Mental & Environmental Demands: To comply with the Rehabilitation Act of 1973 the essential physical, mental and environmental requirements for this job are listed below. These are requirements normally expected to perform regular job duties. Incumbent must be able to successfully perform all of the functions of the job with or without reasonable accommodation. To apply, visit https://careersucirvine.ttcportals.com/jobs/4898136-clinical-appeals-nurse-patient-financial-services-ft-days Copyright 2017 Jobelephant.com Inc. All rights reserved. Posted by the FREE value-added recruitment advertising agency jeid-bb5d2eafbb52b84bb1473e0f9b91e5be
|
Internal Number: 1967020
About University of California Irvine (UCI)
Since 1965, the University of California, Irvine has combined the strengths of a major research university with the bounty of an incomparable Southern California location. UCI's unyielding commitment to rigorous academics, cutting-edge research, and leadership and character development makes the campus a driving force for innovation and discovery that serves our local, national and global communities.
BACK TO TOP