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Nurse Revenue Specialist - Admission Review ***Temporary*** Job
| Company: | Allina Hospitals & Clinics Company Profile | Current Opportunities (154) |
| Job Location(s): | Minneapolis |
| Employment Term: | Regular |
| Employment Type | Part Time |
| Start Date: | As soon as possible |
| Starting Salary Range: | Not Provided |
| Required Experience: | Open |
| Related Categories: | Healthcare - Nursing |
Position Description
Date: Nov 6, 2009
Location: Minneapolis, MN, US
Job Title: Nurse Revenue Specialist - Admission Review ***Temporary***
Business Unit: Corporate Office
Job ID: 417615
Cost Center: RCM Financial Clearance Admin
Location: Corporate Offices - Mpls
Union Position? N
Full/Part Time: Part-Time
Standard Hours: 36.00
Regular/Temporary: Regular
Introduction:
Allina Hospitals & Clinics is a not-for-profit system of hospitals, clinics and other health care services with more than 23,500 employees, 5,000 physicians and 2,500 volunteers dedicated to meeting the lifelong health care needs of patients and communities throughout Minnesota and western Wisconsin. Allina is a vibrant, growing organization with opportunities to suit your professional skills and a diverse work environment to match your specific interests. We believe employees are our greatest asset and are dedicated to helping you develop and maximize your professional skills
Allina Commons is the Minneapolis-based headquarters of Allina Hospitals & Clinics, a not-for-profit health care organization serving patients and communities. Approximately 1,600 corporate and administrative service employees work at offices within Midtown Exchange, site of the historic Sears retail complex at Chicago Avenue and E. Lake Street. This community landmark, adjacent to the campus of Allina's Abbott Northwestern Hospital, is the second largest building in Minnesota and includes offices, an internationally themed public market and residential units.
Responsibilities:
Assess inpatient and observation admission according to admission criteria for all different hospital disciplines (Mental Health, Substance Abuse, Acute Care, Rehab, Observation, etc.)
Assess clinical data from medical records to assure appropriateness of patient's admission.
Ensure proper authorization requirements are met with each admission.
Monitor continued stay, identify potential issues, and communicate the results and opportunities to nurses, physicians, finance, case managers, and payers.
Provide consultation to medical and nursing staff, health information management, payers, patients, and patients on potential issues with reimbursement of hospitalization.
Evaluate potential denials or payment issues and initiate communication with physician and / or clinician to assure proper documentation for selected admission status.
Assure proper physician order is in the record for the correct patient status. If the order is incorrect, facilitate discussion with the appropriate physician.
Refers case to a review physician when the treatment request does not meet necessarily per guidelines, when guidelines are not available, or per customer account instructions. Referrals must be made in a timely manner, allowing the review physician time to make appropriate contact with the attending provider.
Qualifications:
RN - BSN preferred.
3-5 years of acute care experience preferred.
Understanding/ knowledge of Interqual and Milliman and Roberson Admission criteria, preferred.
Knowledge of medicare, medicaid, and other third party payer admission requirement.
Knowledge of managed care concepts including utilization management, prior authorizations, and denial and appeal process.
Pay, Benefits, & Work Schedule
***Temporary position*** 3 - 6 month assignment
36 hours per week
Day and Evening shifts
Every other weekend
We have a place for you at Allina Hospitals & Clinics. If you are interested in becoming part of our award winning team of professionals, please apply online today. Allina Hospitals & Clinics is committed to providing Equal Employment Opportunities to all employees and applicants.
EEO / AA
Business Unit: Corporate Office
Job ID: 417615
Cost Center: RCM Financial Clearance Admin
Location: Corporate Offices - Mpls
Union Position? N
Full/Part Time: Part-Time
Standard Hours: 36.00
Regular/Temporary: Regular
Introduction:
Allina Hospitals & Clinics is a not-for-profit system of hospitals, clinics and other health care services with more than 23,500 employees, 5,000 physicians and 2,500 volunteers dedicated to meeting the lifelong health care needs of patients and communities throughout Minnesota and western Wisconsin. Allina is a vibrant, growing organization with opportunities to suit your professional skills and a diverse work environment to match your specific interests. We believe employees are our greatest asset and are dedicated to helping you develop and maximize your professional skills
Allina Commons is the Minneapolis-based headquarters of Allina Hospitals & Clinics, a not-for-profit health care organization serving patients and communities. Approximately 1,600 corporate and administrative service employees work at offices within Midtown Exchange, site of the historic Sears retail complex at Chicago Avenue and E. Lake Street. This community landmark, adjacent to the campus of Allina's Abbott Northwestern Hospital, is the second largest building in Minnesota and includes offices, an internationally themed public market and residential units.
Responsibilities:
Assess inpatient and observation admission according to admission criteria for all different hospital disciplines (Mental Health, Substance Abuse, Acute Care, Rehab, Observation, etc.)
Assess clinical data from medical records to assure appropriateness of patient's admission.
Ensure proper authorization requirements are met with each admission.
Monitor continued stay, identify potential issues, and communicate the results and opportunities to nurses, physicians, finance, case managers, and payers.
Provide consultation to medical and nursing staff, health information management, payers, patients, and patients on potential issues with reimbursement of hospitalization.
Evaluate potential denials or payment issues and initiate communication with physician and / or clinician to assure proper documentation for selected admission status.
Assure proper physician order is in the record for the correct patient status. If the order is incorrect, facilitate discussion with the appropriate physician.
Refers case to a review physician when the treatment request does not meet necessarily per guidelines, when guidelines are not available, or per customer account instructions. Referrals must be made in a timely manner, allowing the review physician time to make appropriate contact with the attending provider.
Qualifications:
RN - BSN preferred.
3-5 years of acute care experience preferred.
Understanding/ knowledge of Interqual and Milliman and Roberson Admission criteria, preferred.
Knowledge of medicare, medicaid, and other third party payer admission requirement.
Knowledge of managed care concepts including utilization management, prior authorizations, and denial and appeal process.
Pay, Benefits, & Work Schedule
***Temporary position*** 3 - 6 month assignment
36 hours per week
Day and Evening shifts
Every other weekend
We have a place for you at Allina Hospitals & Clinics. If you are interested in becoming part of our award winning team of professionals, please apply online today. Allina Hospitals & Clinics is committed to providing Equal Employment Opportunities to all employees and applicants.
EEO / AA
Nearest Major Market: Minneapolis
Job Segments: Healthcare, Nursing