What are the responsibilities and job description for the Revenue Recovery RN position at UCHealth?
Description
Location : UCHealth UCHlth Admin Lowry, US : CO : Denver; This position can be located in Southern Colorado, Denver / Metro, or Norther Colorado; candidate must reside in Colorado.
Department : UCHlth Denials Mgt Payer Audit
FTE : Full Time, 1.0, 80.00 hours per pay period (2 weeks)
Shift : Days
Pay : $37.06 - $57.44 / hour. Pay is dependent on applicant's relevant experience
Summary :
Recovers potential loss in revenue due to payor denials or defense audits. Facilitates accurate reimbursement through appeal writing, conducts chart review of charge capture to documentation, and provides feedback for process opportunities.
Responsibilities :
- Writes clinical appeals to payors to recover denials. Coordinates with payors to conduct RN reviews and facilitates MD to MD peer reviews as necessary. Applies payor specific clinical criteria to review and determine the appropriate level of care. Participates in payor defense audits.
- Reviews charts to determine if charges support the documentation. Assesses line item overcharges, undercharges, and late charges. Tracks all audit findings. Communicates opportunities to mitigate audit risk. Resolves customer service and employee issues, utilizing proactive intervention.
- Coordinates new or revised procedures and policies. Analyzes process effectiveness; recommends changes as appropriate. Maintains knowledge of Federal, State and local billing regulations and partners with Managed Care contracting or compliance department on discrepancies.
- Maintains knowledge of ADT, registration and pre-admit / admit processes. Maintains knowledge of contracts, billing, follow up, and cash applications processes.
- Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.
Requirements :
Preferred :
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UCHealth invests in its Workforce.
UCHealth offers a Five Year Incentive Bonus to recognize employee's contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of five years' employment.
UCHealth offers their employees a competitive and comprehensive total rewards package :
Loan Repayment :
UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified.
UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, color, national origin, language, culture, ethnicity, age, religion, sex, disability, sexual orientation, gender, veteran status, socioeconomic status, or any other characteristic prohibited by federal, state, or local law. UCHealth does not discriminate against any qualified applicant with a disability as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.
Who We Are (uchealth.org)
Salary : $37 - $57
