Case Management, Clinical Data, Clinical Nursing, Clinical Outcomes, Clinical Support, Discharge Plans, Licensed Practical Nurse/Licensed Vocational Nurse, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft Word, Nursing, Organizational Skills, SAP BusinessObjects, Social Work, Staff Requirements, Time Management, Writing Skills
Shift: Fulltime Days. M-F 8:00am-5:00pm
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Pre-Employment Requirements:
- We are a drug free facility. Passing a pre-employment drug screening is required.
Position goal:
- Responsible for influencing positive clinical and financial outcomes of a designated caseload of patients.
- Responsible for timely entry, follow-up and management of appeals according to payer rules.
- Writes appeal letters addressing the reason for denial with clinical data to support appeal.
- Communicates with all parties involved in the denial process, including but not limited to, BO, Case Management, Payers, HIM.
Education Requirements:
Applicant must be an LPN/RN or Social Worker.
- Nurse Requirements:
- Graduate from an accredited school of nursing.
- LPN or RN license required.
- Current licensure in the State of Alabama is required.
- Bachelors of Science in Nursing preferred.
- Social Worker Requirements:
- Graduate from an accredited school of Social Work.
- Current licensure in the State of Alabama required.
Experience:
- Minimum of one year of Case Management and/or Discharge Planning experience required.
- Clinical nursing experience.
- Must demonstrate critical thinking skills and decision-making ability.
- Demonstrates the ability to carry out detailed written or verbal instructions independently.
- Working Knowledge of Microsoft Office (Word, Excel, and PowerPoint)
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Springhill Hospitals Inc