Remote Clinical Appropriateness Management - Authorization and Appeals Nurse Louisville, Kentucky
Kindred Transitional Care Hospitals has a career opportunity for you! As a division of Kindred Healthcare, we play a vital role in the recovery process for chronic, critically ill and medically complex patients who require acute care and rehabilitation over an extended period.
Your career growth begins when you join an interdisciplinary team, where doctors, nurses, therapists and other experts work together to form individualized care plans for our patients and residents. Opportunities through our development programs, training seminars and university partnerships, not only allow for continual career growth but emphasize our commitment to investing in our employees and developing future healthcare leaders.
The goal of our team is to deliver intensive, multidisciplinary care and transition patients' home or to a lower level of care as quickly and safely as possible. Each employee's dedication is essential to meet and exceed the needs of each patient, resident and family we serve. Ranked as one of Fortune magazine's 'Most Admired Healthcare Company' for 8 years, Kindred welcomes you to join our team and build a career that touches lives.
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.
- 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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