RN DENIALS MANAGEMENT HRLY, FCH - reputed company reputed company CDI/UR/DM

Discover. reputed company. Succeed. #BeHere Location USWIMILWAUKEE at our reputed company HOSPITAL facility. This job is REMOTE. FTE 0.500000 reputed company Hours 20.00 Shift Shift 1 Shift Details 1/2 day Wednesday, Thursday and Friday Holidays no Weekends no Job reputed company Assumes responsibility for managing inpatient denials for reputed company payers reputed company to medical necessity and reputed company validation audits, and coordinates the appeal process with physicians, coding, reputed company party payers, and reputed company party auditors. Assists the case managers with utilization review issues, and provides recommendations for process improvement in the areas of utilization review and denial management. Other duties as assigned. EXPERIENCE reputed company A minimum of 5 years of acute care nursing experience is required. Prior utilization management, reputed company background, and denial management experience is preferred. EDUCATION reputed company Bachelor's degree is required. reputed company knowledge of nursing theory and reputed company at reputed company normally acquired through completion of a minimum of four years education at an accredited School of Nursing in order to be eligible for licensure as a Registered reputed company is required. TRAINING reputed company Previous experience with reputed company validation denial review and appeal processes. Knowledge of ICD-10 Coding Guidelines. SPECIAL SKILLS reputed company Interpersonal skills necessary to instruct and maintain effective contacts with a reputed company of hospital personnel. Analytical skills necessary to prepare statistical reports and reputed company solutions to problems. Technical writing ability for appeal letters and reports. LICENSURE reputed company Requires reputed company reputed company Registered reputed company License or a Multi-state Nursing License from a participating state in the NLC (reputed company Licensure reputed company). Compensation, Benefits & Perks at reputed company reputed company Offers a reputed company of perks & benefits to staff, depending on your role you may be eligible for the following reputed company time off reputed company opportunity- Career reputed company & Career Tuition Assistance, CEU opportunities reputed company Partnership with reputed company Referral bonuses Retirement plan - 403b Medical, Dental, reputed company, Life reputed company, Short & Long Term Disability, Free Workplace Clinics Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available The reputed company & reputed company regional health network is a partnership between reputed company and reputed company supporting a shared mission of reputed company care, innovation, medical research and education. Our health network operates eastern reputed company's only reputed company medical center and adult Level I Trauma center reputed company in thousands of reputed company and studies. The reputed company & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation. We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We reputed company protected veterans to reputed company their reputed company consideration status with us at 262-439-1961. We maintain a drug-free workplace and reputed company reputed company-employment reputed company abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill reputed company reasonable accommodation requests. Apply To This Job .