REMOTE CALIFORNIA - Authorization and Appeals NurseLas Vegas, Nevada
What makes Kindred Healthcare a great place to work? Our people, of course! Our clinicians answer this special calling because they have a fundamental, internal drive to directly help people. In return, we serve, develop and respect our employees in environments created to optimize their job effectiveness, experience, and satisfaction. This is who we are.
Who are you? To succeed in our high-energy, high-reward environment, our clinicians provide compassionate critical care and deliver exceptional patient experiences, meaningful outcomes, and bonds for life.
As our most acute level of care, Kindred’s transitional care hospitals offer the same critical care patients receive in a traditional hospital or intensive care unit, but for an extended recovery period. Our clinicians play a vital role in the recovery process for chronic, critically ill and medically complex patients.
As an Authorization & Appeals Management Nurse you will:
- Combine strong relationship building skills and clinical knowledge to manage the Authorization and Appeals Management process.
- Responsible for investigating and processing appeal requests and authorizations.
- Primary duties include review of prospective, retrospective or concurrent medical records of denied services for medical necessity, as well as processing authorizations.
- Serves as a liaison with marketing, business office and administration of the facilities.
- Coordinates the managed care determinations and distributes information to the marketing and admissions support staff across multiple markets.
- Identifies information needed from the referring hospital to finalize the authorization.
As an Authorization & Appeals Management Nurse you will have:
- Bachelor's degree in clinical area strongly preferred.
- Healthcare professional licensure required as Registered Nurse, LPN, Respiratory Therapist, Physical Therapist, Occupational Therapist or Social Worker.
- Three years healthcare experience.
- Proven history of effective relationship management in a matrix reporting structure.
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