NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the , a National Cancer Institute designated comprehensive cancer center, and , which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. At NYU Langone Health, equity, diversity, and inclusion are fundamental values. We strive to be a place where our exceptionally talented faculty, staff, and students of all identities can thrive. We embrace diversity, inclusion, and individual skills, ideas, and knowledge. For more information, go tonyulangone.org, and interact with us on,,,Facebook,Twitter,YouTubeandInstagram.
Position Summary:
We have an exciting opportunity to join our team as a Senior Specialist - Clinical Denials.
In this role, the successful candidate works with the Assists Director in the overall coordination of daily workflow to the Appeal Writers for all NYU campuses. Will analyze and appeal denials that have been concurrently and retrospectively denied while identifying and presenting both Process Improvement and Revenue Protection opportunities. Will provide training and education to new appeal writers as the scope of the Internal Appeals team expands to the other campuses.
Job Responsibilities:
Minimum Qualifications:
To qualify you must have a Minimum of 5 years of well-rounded clinical nursing experience in an acute care setting, with 3 to 5 years Clinical Denials and Appeals experience
Minimum of three years of case management experience.
Bachelors degree in Nursing
Active RN license
Masters degree in Nursing or other health related field (or in process).
Demonstrates and maintains ongoing responsibility for professional development.
Ability and willingness to work a flexible schedule to ensure compliance with deadlines.
Strong communication (verbal and written) and interpersonal skills.
Ability to communicate with multiple levels of the organization; Senior Leadership, Physicians, Directors, Clinical and Support Staff.
Demonstrates critical thinking and analytical skills.
Ability to work collaboratively in a team environment.
Demonstrates the ability to handle multiple assignments and carry out work independently with minimal supervision.
Proficient with Microsoft applications and working knowledge of hospital based clinical computer systems..
Required Licenses: Registered Nurse License-NYS
Preferred Qualifications:
Experience preparing appeals for Clinical Denials
Minimum of three years of experience in leadership or managerial role.
EPIC experience
Familiarization with MCG Guidelines
Familiarization with Interqual Criteria
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view NYU Langone Health's EEO policies, please . Please to view the Federal "EEO is the law" poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.
NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $97,589.95 - $137,800.00 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.
To view the Pay Transparency Notice, please