RN - Revenue Cycle Clinical Reviewer
: Job Details :

In collaboration with the Revenue Cycle departments and IT, is responsible for the identification, mitigation, and prevention of clinical denials as well as chart to charge auditing. Assists in obtaining prior authorizations where clinical information is required or additional procedures may need authorized. Reviews clinical denials to determine next steps and conducts appeals as appropriate, as well as works to prevent future denials by communicating with clinical and revenue cycle leadership about denial root causes and by developing and implementing staff education and process changes.Registered nurse with at least 5 years of hospital patient care experienceStrong computer skills, including knowledge of billing software functionality and PC-based productivity tools (e.g. spreadsheets, word processing, email).Ability to research, analyze and problem solve.Excellent organization and time management skills, and the ability to effectively establish priorities required.Must project a mature, compassionate, customer-focused attitude and professional demeanor.