Pool Denial & Appeal Coordinator, Concurrent Denials Prevention, PRN, 08:30A-5P
Coral Gables, Florida
Employer: Baptist Health South Florida
Industry: Corporate
Salary: $45.00 per hour
Job type: Full-Time
Baptist Health South Florida is the region's largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. Baptist Health is supported by philanthropy and committed to its faith-based charitable mission of medical excellence.
Our mission, vision, and values make us who we are at Baptist Health and are at the center of everything we do. At Baptist Health, we positively impact the human experience for patients, employees, and physicians. Our success comes from a culture of quality and dedication that is instilled into every member of the Baptist Health family.
This year, and for 24 years, we've been named one of Fortune's 100 Best Companies to Work For, based on employee feedback. We've also been recognized as one of America's Most Innovative Companies and People Magazine included us in 50 Companies That Care. Based on the U.S. News & World Report 2023-2024 Best Hospital Rankings, Baptist Health is the most awarded healthcare system in South Florida, with its hospitals and institutes earning 45 high-performing honors.
But really, the reason we're excited to come to work is the people.
Working together, we form personal connections with our colleagues that are stronger than most of us have experienced at other jobs. We develop caring relationships with our patients and their families that go beyond just delivering healthcare. After all, we know what it's like to be in their shoes. Many of us have been patients here and have had family members as patients here. We're committed to delivering quality care in the most compassionate way possible because we feel a personal stake in the outcomes. When it comes to caring for people, we're all in.
Description
Functions as a lead member of the Care Coordination team to ensure high quality patient care, appropriate length of stay, efficient resource utilization and ensure reimbursement for services rendered. Collaborates with all members of the health care team to prevent insurance denials and discharge delays. The focus is on care appropriateness and quality, specifically decreasing inappropriate admissions, avoidable days and readmissions. Serves as a resource to the hospital for utilization management issues. Estimated pay range for this position is $45.00 / hour depending on shift as applicable.
Qualifications:
Functions as a lead member of the Care Coordination team to ensure high quality patient care, appropriate length of stay, efficient resource utilization and ensure reimbursement for services rendered. Collaborates with all members of the health care team to prevent insurance denials and discharge delays. The focus is on care appropriateness and quality, specifically decreasing inappropriate admissions, avoidable days and readmissions. Serves as a resource to the hospital for utilization management issues. Estimated pay range for this position is $45.00 / hour depending on shift as applicable.Degrees: Bachelors Licenses & Certifications: Registered Nurse Additional Qualifications: BSN. Hospital clinical experience, 3 years UR/CM experience, written and verbal communication and interpersonal skills, knowledge of reimbursement principles. Certified Case Manager, Certified Professional Health Management, Certified Care Guidelines Specialist in Utilization Management or eligble to pursue within one year of employment. Minimum Required Experience: 3Degrees: Bachelors Licenses & Certifications: Registered Nurse Additional Qualifications: BSN. Hospital clinical experience, 3 years UR/CM experience, written and verbal communication and interpersonal skills, knowledge of reimbursement principles. Certified Case Manager, Certified Professional Health Management, Certified Care Guidelines Specialist in Utilization Management or eligble to pursue within one year of employment. Minimum Required Experience: 3
Our mission, vision, and values make us who we are at Baptist Health and are at the center of everything we do. At Baptist Health, we positively impact the human experience for patients, employees, and physicians. Our success comes from a culture of quality and dedication that is instilled into every member of the Baptist Health family.
This year, and for 24 years, we've been named one of Fortune's 100 Best Companies to Work For, based on employee feedback. We've also been recognized as one of America's Most Innovative Companies and People Magazine included us in 50 Companies That Care. Based on the U.S. News & World Report 2023-2024 Best Hospital Rankings, Baptist Health is the most awarded healthcare system in South Florida, with its hospitals and institutes earning 45 high-performing honors.
But really, the reason we're excited to come to work is the people.
Working together, we form personal connections with our colleagues that are stronger than most of us have experienced at other jobs. We develop caring relationships with our patients and their families that go beyond just delivering healthcare. After all, we know what it's like to be in their shoes. Many of us have been patients here and have had family members as patients here. We're committed to delivering quality care in the most compassionate way possible because we feel a personal stake in the outcomes. When it comes to caring for people, we're all in.
Description
Functions as a lead member of the Care Coordination team to ensure high quality patient care, appropriate length of stay, efficient resource utilization and ensure reimbursement for services rendered. Collaborates with all members of the health care team to prevent insurance denials and discharge delays. The focus is on care appropriateness and quality, specifically decreasing inappropriate admissions, avoidable days and readmissions. Serves as a resource to the hospital for utilization management issues. Estimated pay range for this position is $45.00 / hour depending on shift as applicable.
Qualifications:
Functions as a lead member of the Care Coordination team to ensure high quality patient care, appropriate length of stay, efficient resource utilization and ensure reimbursement for services rendered. Collaborates with all members of the health care team to prevent insurance denials and discharge delays. The focus is on care appropriateness and quality, specifically decreasing inappropriate admissions, avoidable days and readmissions. Serves as a resource to the hospital for utilization management issues. Estimated pay range for this position is $45.00 / hour depending on shift as applicable.Degrees: Bachelors Licenses & Certifications: Registered Nurse Additional Qualifications: BSN. Hospital clinical experience, 3 years UR/CM experience, written and verbal communication and interpersonal skills, knowledge of reimbursement principles. Certified Case Manager, Certified Professional Health Management, Certified Care Guidelines Specialist in Utilization Management or eligble to pursue within one year of employment. Minimum Required Experience: 3Degrees: Bachelors Licenses & Certifications: Registered Nurse Additional Qualifications: BSN. Hospital clinical experience, 3 years UR/CM experience, written and verbal communication and interpersonal skills, knowledge of reimbursement principles. Certified Case Manager, Certified Professional Health Management, Certified Care Guidelines Specialist in Utilization Management or eligble to pursue within one year of employment. Minimum Required Experience: 3
Created: 2024-09-04
Reference: 348483
Country: United States
State: Florida
City: Coral Gables