80 hours/pay period (bi-weekly), Monday-Friday, 8:00am-5:00pm
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We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. As Colorado's largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it's a passion. <!--[if !supportLineBreakNewLine]--> <!--[endif]-->
Utilizes leadership and analytical skills to recover potential loss in revenue as a result of payer denials. As denials are received, determine if appeals should be filed; initiates and files appeals in a timely manner and manage denied appeals within the timeframes and guidelines of each given payer.
Coordinate response and appeal activities of those other stakeholders in payer audits including legal counsel, health information management, the business office, etc..
Serve as a Recovery Audit Contractor (RAC) audit program subject matter expert (SME) and attend ongoing RAC Advisory Committee meetings. This may include working with the Government Audit Program Administrator to compile materials and reports with follow up communication as needed.
Track status of payer audit activities by the use of the department's automated tracking system.
Participate in system wide audit activities including RAC and other government agencies.
Associate's Degree in Nursing or in a Healthcare related field.
3 years of related healthcare coding experience for both inpatient and outpatient hospital settings OR 3 years of experience in acute care nursing.
1 year of Utilization Management/Case Management experience OR previous denial management experience
Bachelor's degree or Bachelor's Degree in Nursing preferred.
Utilization Management/Case Management experience OR previous denial management experience.
Registered Health Information Administrator (RHIA) or healthcare-related credential.
Five plus years of related healthcare coding experience in both inpatient and outpatient hospital settings.
Two plus years of health care experience with a specific emphasis on health care operations, government regulatory rules and guidelines, policy development, or compliance.
Going beyond quality requires the perfect balance of talent, integrity, drive and intellectual curiosity. We are looking for individuals who recognize, like us, that the world of medicine is ever-changing and are motivated to do what is right, not what is easy. We support creativity and curiosity so that each of us can find the extraordinary qualities within ourselves. At UCHealth, we'll do everything in our power to make sure you grow and have a meaningful career. There's no limits to your potential here. <!--[if !supportLineBreakNewLine]--> <!--[endif]-->
Be Extraordinary. Join Us Today! <!--[if !supportLineBreakNewLine]--> <!--[endif]-->
The University of Colorado Health (UCHealth) system recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. UCHealth does not discriminate against any "qualified applicant with a disability" as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.
With award-winning hospitals and facilities serving the entire Front Range, University of Colorado Health is the state’s largest and most innovative health system. By integrating the strengths of academic medicine with the finest community health care, we’re able to push the boundaries of medicine and offer our employees endless career opportunities. Here, there are no limits, except those you pla...ce on yourself. Everyone is united by their passion for discovery and their commitment to improving patients’ lives.