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To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Under the general direction of the Senior Manager, Clinical Revenue Management (CRM), the Clinical Revenue Management Specialist (CRMS) performs a wide range of system wide clinical revenue management activities in an attempt to prevent insurer denials, enhance revenue, and to recover payment for services that have been denied. Responsible for the collection of denial and appeal data as well as other clinical documentation when necessary. The CRMS works collaboratively with other members of the CRM department, health care team, Care Coordination, Verification, Clinical Finance Operations (CFO), Contracting and Corporate Business Services (CBS).
EEO/AA/Disability/Veteran
EDUCATION
Current licensure in the State of Connecticut as Registered Nurse with a Bachelors of Science Degree. Masters Degree preferred.
EXPERIENCE
Strongly preferred a minimum of five years of relevant clinical experience in hospital acute care along with relevant experience in case management, care coordination, and/or utilization management in a hospital or insurance setting. Strongly preferred knowledge of finance and billing practices
LICENSURE
Current licensure in the State of Connecticut as Registered Nurse.
SPECIAL SKILLS
Excellent communication, negotiation and organizational skills. Adaptability to a wide variety of interpersonal encounters with the entire hospital team. Comprehensive understanding in use of medical record to extract data. Working knowledge of third party and prospective payment systems. Computer/PC literacy required. Proficient in Microsoft Office including but not limited to Word, Outlook and Excel. Knowledge of EPIC strongly preferred. Will be trained in use of professionally recognized criteria, ICD10-CM Coding, Diagnostic Related Grouping (DRG). Must be able to work collaboratively and independently. Must be flexible with responsibilities in order to meet departmental needs.
YNHHS Requisition IDPer Diem
Ancillary Healthcare
$93k-119k (estimate)
03/25/2024
05/07/2024
ynhhs.org
MYSTIC, CT
50 - 100
1996
$5M - $10M
Ancillary Healthcare
Yale New Haven Health is making it easier for people to access the latest medical treatments, advanced research and innovations through our five outstanding hospitals Yale New Haven, Bridgeport, Greenwich, Lawrence + Memorial and Westerly and our affiliation with the prestigious Yale University and its highly-ranked Yale School of Medicine. Plus, our patients benefit from access to hundreds of dedicated primary care physicians and specialists in Northeast Medical Group and Yale Medicine. We also have advanced clinical relationships with multiple hospitals and numerous outpatient locations th...roughout the state so you can get the care you need, when you need it. As one organization, were working together to make health care more patient-focused, more accessible and more cost-effective. Some call it personalized medicine. We call it good care. For more information, check out the YNHHS Web site: www.ynhhs.org
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