Registered Nurse Clinical Denials Appeals

Are you a compassionate and detail-oriented Registered Nurse looking for an opportunity to make a difference in the lives of pediatric patients? Children's Hospital Colorado is seeking a skilled and dedicated Registered Nurse to join our team as a Clinical Denials Appeals specialist. In this role, you will play a crucial part in advocating for the best possible care for our young patients by managing and appealing clinical denials. If you have a strong clinical background, excellent communication skills, and a passion for helping children, we encourage you to apply for this exciting opportunity.

1. Review and analyze clinical denials to identify potential appeals for pediatric patients.
2. Collaborate with other healthcare professionals to gather necessary information for appeals.
3. Utilize strong clinical knowledge and understanding of insurance policies to develop effective appeals.
4. Serve as an advocate for pediatric patients by presenting evidence-based arguments for clinical denials.
5. Maintain accurate and detailed records of appeals process and outcomes.
6. Communicate with insurance companies and other relevant parties to ensure timely and effective resolution of appeals.
7. Educate and train clinical staff on best practices for preventing and appealing clinical denials.
8. Stay up-to-date on industry trends and changes in insurance policies to inform appeal strategies.
9. Work closely with hospital leadership to develop and implement strategies for reducing clinical denials and improving reimbursement rates.
10. Provide support and guidance to families of pediatric patients during the appeals process.
11. Adhere to all hospital policies and procedures, as well as ethical and legal standards, when handling appeals.
12. Participate in relevant meetings and committees to provide insights and recommendations for improving the appeals process.
13. Maintain confidentiality of patient information and ensure compliance with HIPAA regulations.
14. Continuously evaluate and improve the appeals process to ensure the best possible outcomes for pediatric patients.
15. Uphold the mission and values of Children's Hospital Colorado in all aspects of the role.

According to JobzMall, the average salary range for a Registered Nurse Clinical Denials Appeals in Aurora, CO, USA is $70,000 to $90,000 per year. However, this can vary based on years of experience, education level, and specific job responsibilities. Additionally, some employers may offer bonuses or other benefits that could impact the overall salary. It is best to research the specific job posting or company for more accurate salary information.

Children's Hospital Colorado is a academic pediatric acute care children's hospital located in the Anschutz Medical Campus near the interchange of I-225 and Colfax Avenue in Aurora, Colorado. The hospital has 434 pediatric beds at its main campus in Aurora.