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Position informationCompany: Location: Status: Job Category: Occupations: Relevant Work Experience: Career Level: Industry: Education Level: contact information |
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Memorial Hospital has opportunities that no other hospital can offer. In addition to being easy to reach, we have a collegial and supportive atmosphere. We have an outstanding team that is dedicated to life-long learning and quality patient-centered care. We know how important it is to show our appreciation for our staff and do everything we can to make sure they feel valued. You can grow personally and professionally and enjoy excellent benefits and experience work/life balance. With our opportunities and your skills, imagine what we can accomplish. Visit us online at www.mhri.org for more information or email us at Careers@mhri.org. We are an equal opportunity employer (EOE M/F/D/V) position descriptionRegistered Nurse/Appeals Coordinator-ACNM
The Assistant Clinical Nurse Manager (Appeals Coordinator) position is available in our Utilization Review Department at Memorial Hospital of Rhode Island. The Appeals Coordinator is responsible to conduct clinical reviews to determine appellate potential in response to clinical disputes for insurer reimbursement; use expert clinical judgment to evaluate medical appropriateness; indentify recovery potential, and intervene when appropriate to attain optimal recovery of resources within established guidelines; support evidence based practice in collaboration with all healthcare disciplines; collaborate with other medical professionals to identify clinical information; be responsible for service denials including conditions for obtaining expedited reconsideration and other recommendations of the appeal process; provide liaison services with third party payers and other agencies to evaluate and interpret insurance coverage to patients, families, physicians, nurses and thereapists as needed. Associates Degree in Nursing is required; BSN preferred. Valid RI licensure is required. Memorial Hospital of Rhode Island is a 294 bed teaching and research facility affiliated with the Warren Alpert School of Medicine at Brown University. We are affiliated with all the regional schools of nursing and allied health. We are Stroke Certified and have a state-of-the-art Cancer Center. We offer competitive salaries and generous benefits including employer paid health and dental, tuition reimbursement and an employer paid pension plan. |
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