Clinical Payer Integrity Nurse

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🕒 July 20

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Logo of UK King's Daughters Workforce Institute

UK King's Daughters Workforce Institute

- employees

🏥 Healthcare

📚 Education

Healthcare • Education

UK King's Daughters Workforce Institute is an organization focused on shaping the future of healthcare by preparing and empowering the next generation of healthcare professionals. The Institute appears to concentrate on workforce development, education, training, and professional development initiatives aimed at addressing healthcare staffing needs and improving the skills and readiness of clinical and allied health workers. It operates within the hospitals and health care sector and emphasizes equipping learners and professionals to make meaningful impact in clinical settings.

📋 Description

• Responsible for ensuring accurate reimbursement by resolving denied claims through effective appeals processes • Reviews and analyzes denials to identify root causes and opportunities for successful resolution • Collaborates with clinical and billing teams to gather documentation and support appeals • Develops strategies to retain appropriate reimbursement and monitors outcomes to improve future processes

🎯 Requirements

• Bachelor’s degree in nursing, healthcare administration, or a related field • 2-3 years of experience in clinical review, payer integrity, utilization management, or a relevant area • Must maintain active RN licensure • An equivalent combination of education and experience may be considered

🏖️ Benefits

• Flexible work arrangements • Professional development opportunities

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