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Denials Management Nurse

CHI St Vincent Health Little Rock, Arkansas
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The posted compensation range of $32.75 - $43.24 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Requisition ID 2025-416412 Employment Type Full Time Department Care Management Hours/Pay Period 80 Shift Day Weekly Schedule 8am - 4pm Remote No Category Case Management and Social Work Travel No Union 1119OPEI

Responsibilities

The Denials RN is responsible and accountable for receiving, processing and documenting all concurrent denials for assigned facilities.

The RN has an integral role within the revenue cycle by providing clinical expertise in the denials management process.

The Denials RN  performs a root cause analysis of the concurrent denial, formulates and implements a plan for addressing the specific root cause for that denial, identifies gaps in processes that lead to concurrent denials, documents and communicates findings to management. 

Recommends and provides education in collaboration with their manager.

The Denials RN follows a standardized approach to managing denials in order to achieve the organizational objectives of financial stewardship and patient advocacy through accurate billing.

Incumbents will use professional judgment, independent analysis and critical-thinking skills to apply clinical guidelines, policies, and payer knowledge to ensure the best possible financial outcome.
The Denials RN is accountable for demonstrating a strong commitment to promoting quality every day by demonstrating our organizational values of: Compassion, Inclusion, Integrity, Excellence, and Collaboration.


Qualifications

Unencumbered license to practice in the State of Arkansas 

Bachelors Of Nursing Or related healthcare field

Minimum three (3) years clinical experience as Registered Nurse (RN)

5 years of RN experience

Preferred

Denials management experience

Previous case management, utilization management, or discharge planning experience strongly preferred

Care Management certification (CCM or ACM) or UM Certification

While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, and more! 

Overview

As a RN Denials Management RN at CHI St Vincent, you'll oversee a department of care coordination team supporting our patients and families. Your previous experience in bedside and acute care adds tremendous value to our nursing team.

CHI St. Vincent, a regional health network serving Arkansas, is part of CommonSpirit Health. We have served Arkansas since 1888 with a history of many firsts. Together with more than 4500 coworkers, 1000 medical staff and 500 volunteers we consistently receive praise for care advancements. CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health in 2019. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. CHI St. Vincent provides you with the same level of care you provide to others. We care about our employee well-being and offer benefits that complement and support your work/life balance.We offer the following benefits to support you and your family:Free Premium Membership to our Care@Work program to help employees with child care pet care senior caregivers housekeepers & more.Health/Dental/Vision Insurance Flexible spending accounts Voluntary Protection: Group Accident Critical Illness and Identity Theft Adoption Assistance Employee Assistance Program (EAP) for you and your family Paid Time Off (PTO) Tuition Assistance for career growth and development Matching 401(k) and 457(b) Retirement Programs Wellness Programs.

If you are committed to social justice, health equity, and prepared to deliver care in new, innovative ways, you belong with us. 

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.

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Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.

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Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.