Clinical Denial Analyst

About Montrose Regional Health:

• As the leading healthcare in the Uncompahgre Valley, MRH offers patients personalized and professional healthcare backed by the latest technology experience, and partnership, we continue to evolve and broaden our comprehensive services in 23-specialties and sub- specialties. We are the hospital, the healthcare resource, and the employer of choice in our communities. Montrose Regional Health is a not for-profit accredited by the Joint Commission meeting the highest standards of healthcare.

About the "Department"

• Montrose Regional Health revenue integrity is the auditing and active monitoring to ensure the appropriate level of care or service is billed to the patient.

About The Career:

• The Clinical Denial Analyst is a key contributor within the interdisciplinary Denial Management Program and is responsible for completing, tracking, and reporting clinical denial review determinations. This individual will combine clinical, business, and regulatory knowledge and skill to reduce financial risk and exposure caused by concurrent and retrospective denials. The Clinical Denial Analyst is considered a clinical expert in Denial Management and ensures all medical necessity denials are accurately worked from a clinical perspective and appropriately appealed to secure maximum reimbursement and minimize organizational write-offs.

All About You:

• ASN Degree in Nursing or other relevant healthcare field. Bachelor's in Nursing or other relevant healthcare field, preferred.

• Minimum work experience: Three (3) years' experience working within case management, utilization management or denial management. Experience with business letter writing, e.g., appeals, preferred.

• Must at least be Licensed as a Registered Nurse in the State of Colorado or possess a Compact State License.

• Must have Exceptional oral/written communication skills; the ability to independently research issues and make effective recommendations using critical thinking skills; effective analytical ability to solve complex problems and issues

• Must have excellent customer service skills and ability to work with a diverse group of people; track record demonstrating ability to function independently and as a team member, and consistently deliver quality outcomes

• Must have excellent organizational skills and attention to detail. Competent in MS Outlook, Word, Excel, and PowerPoint.

What We Offer

• Mentoring

• Continuing Education

• 401 K Retirement Plan with employer match plus 457(b) Top Hat Retirement plan

• Multiple health options to selection from

Our Brand:

• Integrity & honesty in everything we do

• Service with care and compassion

• Excellence

• Leadership with innovation & Creativity

• We care for our team like family.

• This position is located in Montrose Colorado