Pros: We got to work at home and set our own hours.
Cons: Believe it or not, There were no 'cons' to my position!!
My responsibilities as a Claims Cost Improvement RN:
• Ensure large dollar claims comply with nationally recognized billing guidelines including CMS and National Correct Coding Initiatives.
• Investigate and resolve provider inquiries and disputes.
• Maintain complete documentation of all regulations which support company cost containment and denial initiatives.
• Keep the CCI Department up-to-date on latest Federal Transmittals, Memoranda, and Change Requests.
• Assist other departments as requested w/ investigation and documentation for their case issues. (Claims; Appeals and Grievances; SIU; etc.)
The Management Team was superior in every way! We had major input into our job descriptions. My position was tailored to my specific interests and talents. We had excellent workplace diversity and support. We had weekly Team Meetings w/ RNs from all nursing specialties and from all over the US. We worked from home, which was wonderful, and we became very close friends. Even though I retired 3 years ago, I still correspond w/ many of my co-workers on a daily basis.
The hardest part of the job was knowing when to call it a day. I would get wrapped up in reviewing a case and totally lose track of time. I loved this position, all the work I did, and working w/ superior RN co-workers and management!!
My salary and the benefits package were EXCELLENT!