Unity Health · 1 hour ago
Clinical Denials Audit Analyst RN, Full Time
Searcy, AR, US
Full-time
Onsite
Entry, Mid Level
2+ years expUnity Health is a healthcare organization seeking a Clinical Denials Audit Analyst RN. This role involves managing claim denials, writing appeals, and handling audit-related responsibilities to ensure hospital and physician reimbursement processes are efficient and compliant.
Health CareHospitalMedicalNon Profit
Responsibilities
Managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, etc
Assisting with the tracking notification and following of denials in Compliance 360
Writing and submitting professional appeals which include compelling arguments based on clinical documentation, third-party payer medical policies, and contract language and coding guidelines
Submitting appeals timely and tracking through until final outcome
Handling audit-related / compliance responsibilities and other administrative duties as required
Working independently to plan, schedule, and organize activities that directly impact hospital and physician reimbursement and assist in creating and maintaining documentation of key processes
Qualification
Required
Minimum of an associate's degree in nursing is required
Current RN license for the state of Arkansas
Two (2) years of relevant experience
Minimum of two (2) years' recent experience in hospital case management and/or hospital revenue cycle required
Experience with medical and insurance terminology, CPT, ICD coding structures, and billing forms
Knowledge of Medicare, Medicaid and third-party reimbursement methodologies and of local, state and federal healthcare regulations
Ability to make good decisions in demanding situations
Focus on continuous process improvement
Effective communication skills
Ability to listen empathically
Extensive writing capabilities
Ability to organize details logically and accurately
Ability to manage multiple tasks easily and efficiently
Work independently and be results oriented
Ability to multitask and use various computer applications
Basic math skills
Knowledge of general accounting principles
Preferred
BSN
Three (3) years of experience in a healthcare revenue cycle or clinic operations role with one (1) of those years being in a role which included claim-related appeal writing
Company
Unity Health
Unity Health is a healthcare center that offers patient and family advisory council services.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Phil Miller
Asst. Vice President/CIO
Roddy Lochala
Chief Medical Officer
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