Mgr - Denial Prevention (South Atlantic Division)
Location: Charleston South Carolina
Description: Trident Medical Center is at present recruited Mgr - Denial Prevention (South Atlantic Division) right now, this career will be placed in South Carolina. For detail informations about this career opportunity please read the description below. Responsible for providing direction & oversight of concurrent denial prevention within the South Atlantic Division Case ! Management department. Maintains a current working knowledge of non-governmental and governmental payers and the contracted language. Knowledge of payer trends and analysis of denials with a focus on prevention of denials within the acute setting.
Will assist with the identification of strategies for prevention and initiate processes for denial avoidance. Monitors and provides detailed analysis of trends in the non-governmental & governmental sector.
Assists South Atlantic Division Facilities with root cause analysis of denials and develops and implements action plans as needed.
Identifies education opportunities for the South Atlantic Division Facilities and provides education communication assistance to the SSC (Shared Services Center) as needed.
Provides for weekly monitoring and dashboard development and review.
Interacts with payers in collaboration with Strategic Pricing and Analytics (SP&A) as required or as needed to reso! lve issues or opportunities of concern.
Has a working! knowledge of URAC Guidelines and credentialing and demonstrated ability in use of InterQual Criteria.
Qualifications
Position Requirements:
Licensure/Certification/Registration:
RN required.
ACM, CCM or CPUR also preferred
Education
:
Bachelor degree preferred
Experience and Qualifications:
a)
Denial/Appeal management experience required with a minimum of 2 yr.
b)
Manager experience preferred
c)
Analytical skill set necessary
d)
Excellent communication skills and customer service oriented
Degree of Supervision Required:
Involves general guidance and direction by Executive.
The employee will be expected to perform most job duties independently and in accordance with established departmental and HCA policies and procedures.
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If you were eligible to this career, please email ! us your resume, with salary requirements and a resume to Trident Medical Center.
If you interested on this career just click on the Apply button, you will be redirected to the official website
This career starts available on: Mon, 05 Aug 2013 07:48:18 GMT
Apply Mgr - Denial Prevention (South Atlantic Division) Here