Recent experience in the specialty area is required
GOVERNMENT DENIAL COORDINATOR
The ideal candidate will have a BSN, an active CO RN license and denial management experience. This is a full-time, exempt/salary position on UCHealth's Government Audits team. This position works from home (75% of the time and 25% on site). You must reside within the State of Colorado. Travel to Metro Denver (Lowry) will be required. Additional occasional regional travel will be required to meet with Physician Advisors and ad hoc as determined by the audit activity when face to face education is needed.
Providesservices to recover potential loss in revenue as a result of payer denials.
At UCHealth, we do things differently
We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. As Colorado's largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it's a passion.
· Analyzes data to recover potential loss in revenue as a result of payer denials. Determines if appeals should be filed; initiates appeals and manages denied appeals within the timeframes and guidelines of each given payer.
· Coordinates response of other stakeholders in payer audits including legal counsel and health information management. Analyzes denial issues and pinpoints trends. Provides feedback regarding workflow improvement opportunities to leadership.
· Serves as a Recovery Audit Contractor (RAC) program subject matter expert. Works with the Government Audit Coordinator to compile materials and reports with follow up communication. Tracks status of payer audit activities.
· Participates in system wide audit activities. Applies industry standard criteria to assist in determination of the appropriate level of patient care. Facilitates accurate reimbursement.
Associate's Degree in Nursing or healthcare related field. Completion of BSN required.
3 years of experience in acute care nursing
1 year of Utilization or Case Management experience OR previous denial management experience
Bachelor's degree in Nursing
Denial management experience
Registered Health Information Administrator (RHIA) or healthcare-related coding certification
5 years of healthcare coding experience in inpatient and outpatient hospitals
2 years of health care experience emphasizing health care operations, government regulatory rules and guidelines, policy development, or compliance
Project management or revenue integrity experience
Going beyond quality requires the perfect balance of talent, integrity, drive and intellectual curiosity. We are looking for individuals who recognize, like us, that the world of medicine is ever-changing and are motivated to do what is right, not what is easy. We support creativity and curiosity so that each of us can find the extraordinary qualities within ourselves. At UCHealth, we'll do everything in our power to make sure you grow and have a meaningful career. There's no limits to your potential here.
Be Extraordinary. Join Us Today!
UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an affirmative action/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, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. 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.
With award-winning hospitals and facilities serving the entire Front Range, University of Colorado Health is the state’s largest and most innovative health system. By integrating the strengths of academic medicine with the finest community health care, we’re able to push the boundaries of medicine and offer our employees endless career opportunities. Here, there are no limits, except those you place on yourself. Everyone is united by their passion for discovery and their commitment to improving patients’ lives.