Denial Resource Center RN

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level.

You, as a Registered Nurse in the Denial Resource Center at Baylor Scott & White Health, manage denials and appeals. Your job is to handle claim denials from all insurance companies, addressing various reasons. SALARY: The pay range for this position is $40.35 (entry-level qualifications) - $62.52 (highly experienced) The specific rate will depend upon the successful candidate’s specific qualifications and prior experience

You receive rejected healthcare claims from financial office or provider. You appeal until resolution following guidelines. Reviewing medical records is important. Verify care levels, admissions, and hospitalizations. Evaluate stay duration and discharge planning. You will contribute to improving processes and protocols by identifying opportunities for enhancement and earnestly participating in their implementation. By closely examining denial trends, you will categorize them based on impacts like diagnosis, type and procedural variations amongst others. You will record denial data and appeal findings in an electronic system. The system helps study denial trends and assess appeal outcomes.