Provide expertise in the areas of clinical and coding practices to other areas within the organization. Review provider appeals, non covered services done at same time as covered services, unlisted codes, possibly covered services and other claims that require clinical and/or coding expertise for claims payment. This position will work with Medicare and Medicaid.
RN licensed in the State of Utah, or license eligible
Five years of RN work experience
Three years of Care Management experience
Three years of health insurance experience
Experience in word processing, internet searches and spreadsheets
Bachelor's degree in nursing
Experience in training and auditing procedures
Clear understanding of health care products, ethics policies, and internal processes
Working knowledge of IDX, Clinical Workstation, AS400, LINC, OVID, and the Internet
Demonstrated teaching and leadership ability
Demonstrated ability in fostering organizational communication
Ability to communicate successfully, professionally and effectively with all individuals, professional and private, in writing and verbally
Ability to establish and maintain rapport with co-workers, physicians, other health care providers, clients
A working knowledge of managed care, ICD-9/CPT 4 coding, length of stay guidelines, and appropriate levels of care and modalities by diagnosis/procedure in multiple clinical areas
Able to work independently, and be self-motivated with a positive attitude and flexibility in a rapidly changing environment
Experience in utilization management
Coding certification from a nationally recognized organization (e.g. American Academy of Professional Coders - AAPC or "American Health Information Management Association � AHIMA).
All positions subject to close without notice
Intermountain Healthcare is an equal opportunity employer M/F/D/V
Intermountain Healthcare is an internationally recognized system of 22 hospitals and a full range of medical services, multi-specialty...