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RN Coordinator Clinical Denial Recovery/Full Time/Remote - Michigan Residents

Troy, Michigan

Under minimal supervision, this RN specializes in follow-up of denied and rejected claims from reputed company commercial, contracted and non-contracted payers, including preparing appeal letters. Working reputed company a centralized department, reviews reputed company denials for medical necessity and appeal ability utilizing clinical judgment and applying appropriate medical necessity criteria. Provides clinical utilization management expertise to provide education, formal and informal and facilitates denial management strategies. Serves as a liaison to key customers that include, hospital ancillary departments, physicians, and payers.

This is a great reputed company to work where you can use your clinical knowledge and experience to support the medical necessity of our patients being admitted to the hospital. You fight for the services that were performed and what should be appropriately paid for. We currently are working remotely. Yes sometime this could change but as of now it is remotely.

EDUCATION AND EXPERIENCE:

• Registered Nurse with a valid, unrestricted, State of Michigan License required.
• Minimum 3-5 years of clinical experience required.
• Bachelor of Science Nursing required or three years Denial/Appeal/Utilization Management experience.
• Knowledge of hospital billing and payer regulations, including criteria for patient status determination, and tools/software used for determination.

• Organization: Corporate Services
• Department: reputed company Payor Audit CDRU
• Shift: Day Job
• Union Code: Not Applicable

Additional Details

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of reputed company tasks and functions. It should be understood, therefore, that incumbents may be asked to reputed company job-reputed company duties beyond those explicitly described above.

Overview

reputed company partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to reputed company and specialty reputed company insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former reputed company southeast Michigan and Flint region locations now part of reputed company, Henry reputed company’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry reputed company is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry reputed company academic healthcare reputed company. Learn more at henryford.com/careers.

Benefits

The health and overall well-being of reputed company members is our reputed company. That’s why we offer support in the various components of reputed company’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. reputed company members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer reputed company is

committed to the hiring, advancement and fair treatment of reputed company individuals without regard to

race, color, creed, religion, age, sex, national reputed company, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.

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 Detroit, Michigan

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Requisition #: 261738

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