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.
At Bridgeport Hospital, we are committed to providing quality medical care and treatment that is coordinated and centered on the patient’s specific needs. We strive to achieve benchmarks as a Patient Centered Medical Home and provide health care in a setting where patients are at the center of their care team. All employees of Bridgeport Hospital are part of the patients care team and contribute to the team approach of promoting access, continuous, comprehensive care and work to provide quality improvement in the care provided to their patients.
This position reports directly to the Sr. Vice President, Finance. Responsible for all aspects of Denial Management. Works closely with System Billing Office in ensuring a comprehensive denial review and appeal process. Serves as a strong liaison to the Utilization Review staff and Physician Advisors in ensuring an appropriate utilization review and patient status assignment process. Serves as a clinical liaison to Access/Verification, Contracting, and Compliance.
EDUCATION: RN required
EXPERIENCE: At least 5 years of acute care clinical experience and utilization review experience preferred.
Knowledge of Excel, Word. Knowledge of InterQual criteria required. Strong positive interpersonal skills and communication skills required. Strong public speaking presentation skills preferred.
Responsible for all aspects of denial management and audit contractors as related to the overall revenue cycle at Bridgeport Hospital. In personal and job-related decisions and actions, consistently demonstrates the value of integrity (doing the right thing), patient centered care (putting patients and families first), respect (valuing all people and embracing all differences), accountability (being responsible and taking action) and compassion (being empathetic).
COMPLEXITY: Serves as the on-site expert in Clinical Denial Management and Utilization Review.
LICENSURE/CERTIFICATION: RN license required.