Pay range for this position is $39.37 - $56.73/hour. Actual pay is based on years of licensure.
POSITION SUMMARY: The Lead is responsible for overseeing Clinical Denials and Appeals (CDA) unit that produces accurate and timely clinical appeals. Lead will assist the manager in tracking and trending denials for prevention along with reporting trending denials to those outside revenue cycle including utilization management, case management and other clinical service lines. Also, acts as a resource for CDA team in developing clinical appeals.
This is a hybrid/remote-working schedule at the discretion of leadership after training and orientation are complete.
Qualifications
REQUIRED QUALIFICATIONS:
- Education: Bachelor’s degree in nursing
- Experience: 1 year of clinical denials and appeals work experience.
- Licensure/ Certification: IL RN License
- Other Skills/ Knowledge: Excellent interpersonal and communication skills.
- Solid computer skills, including proficiency with Microsoft software.
- Strong analytical and problem-solving skills, with the ability to be detail oriented.
- Understanding of medical and payer terminology.
- Communicates professionally with internal and external contacts.
PREFERRED QUALIFICATIONS:
- Experience: 1 year of clinical denials and appeals work, AND 3 years of Utilizations Management (UM) or clinical nursing.
OSF HealthCare is an Equal Opportunity Employer.