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Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. Become a part of our caring community and help us put health first.
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The RN - Utilization Review Nurse Manager shall manage the daily Utilization Review and Appeals Management processes for the facilities within Baptist Health. Minimum 3-5 years of hospital-based appeals management experience required.
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First-hand experience in the negotiation and administration of union collective bargaining agreements, grievance handling, and union performance management. This is a fully remote position open to candidates based anywhere in the U.S.
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Ensures all program requirements imposed by Compensation Service and/or the Pension and Fiduciary Service and the Court of Appeals for Veterans Claims are met or implemented. Technical Competence - Knowledge of veteran-based state and federal laws (dependency status, social services programs, Medicaid, special income-based programs), to include legal opinions from (1) the court of Appeals for Veterans' Claims (CAVC) and (2) state and federal courts having a relationship to VA programs.
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Summary:The RN – Utilization Review Nurse Manager shall manage the daily Utilization Review and Appeals Management processes for the facilities. Summary:The RN – Utilization Review Nurse Manager shall manage the daily Utilization Review and Appeals Management processes for the facilities.
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This individual shall develop and maintain an organized and structured process for facilitating appeals and recoveries to ensure denials and underpayments are appealed in a timely manner in accordance with payer and regulatory requirements.
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Experience in reviewing and recalculating the collection statute date when OIC, bankruptcy, innocent spouse, CDP appeals, or installment agreements extend the collection statute date. Experience as a liaison between multiple parties such as The Department of Justice, Area Counsel, Taxpayer Advocates Office, Appeals, Disclosure Office, all levels of Collections, Campus, Special Interest Groups and the General Public.
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Review Patient Rights and Responsibilities, Grievance Procedure & Important Numbers Handout, FKC Non-discrimination policy, DNR Statement (if applicable) and address any immediate needs/concerns.
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The incumbent serves on a consulting basis for other Examination Specialists, International Examiners, Counsel Attorneys, Appeals Officers, and Revenue Agents assigned to a Coordinated Industry or Industry Examination regarding transfer-pricing issues and transactions.
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Collaborates and coordinates with other experts, revenue agents, counsel attorneys, appeals officers, and/or specialists throughout IRS to leverage and expand expertise and ensure consistent application and interpretation of tax laws within those areas.
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