• Clinical Appeals Specialist 1

    Category
    Revenue Cycle / Health Information Management
    Department
    8597-PAYOR REIMBURSEMENT MGMT
    Position Type
    Regular Full-Time
    Work Schedule
    DAY
    Location Name
    Boise
    Requisition ID
    2018-13449
  • Overview

    St. Luke’s Health System has an exciting opportunity for a Clinical Appeals Specialist 1 to join our team! Under limited supervision, the Clinical Appeals Specialist 1, is responsible for managing client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. Maintains knowledge of state and federal guidelines, advisory opinions, updates, bulletins, and other communication related to the revenue cycle and provide updates to appropriate individuals in the organization. Reviews patient medical records and utilizes clinical and regulatory knowledge and skills as well as knowledge of payer requirements to determine why cases are denied and whether an appeal is required.

     

    Required Criteria 
    Education: Associates’ Degree or 2 years equivalent experience in lieu of Associates’ Degree
    Experience: 2 years’ experience in a revenue cycle, health care delivery system, case management or
    utilization management

     

     

    Our employees enjoy many benefits, some of the most popular are tuition reimbursement, hospital retirement contributions, and hospital-supported on-going training and education. If you’re looking for a place where you can grow in your personal life, in your career, and in your community, St. Luke’s may be just the place for you.

    A strong, talented staff is at the heart of St. Luke’s Health System. We are the state’s largest employer with more than 13,500 employees and a medical staff of more than 1,800 physicians and advanced practice clinicians. Our employees are dedicated to impacting the lives of those in our community while pursuing a life- changing career at St. Luke’s. Our staff is the reason for our outstanding reputation as both a quality employer and superior healthcare organization. We’re proud of our people who deliver skilled, compassionate care every day, and are looking to add dedicated individuals who will continue in the same tradition of excellence.

    With multiple locations in the beautiful southern and central Idaho, our mild, four season climate means you can play outdoors year-round. Whether you prefer leisurely walks along the river or heart-pounding climbs up a sheer cliff- there is always something to do after work. An exciting mix of urban and outdoor life defines Idaho’s culture, you can ski in the morning and watch a college sporting event at night. It is a great state to raise a family and forge lasting relationships. The cost of living is low, and quality of life is high.

    __________________ 

    #One of American’s Top 15 Health Systems - U.S.News & World Report, "America's Best Hospitals 2015-2016"

    *St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.

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