Claims Utilisation Nurse CNM1 Clinical Nurse Manager

CNM1
Clinical Nurse Manager 1
Claims Utilisation Nurse
Fixed Term
Part time

Our client a well-established Hospital in North Dublin wishes to recruit a CNM1 Claims Utilisation Nurse. This is a part time position, fixed term.

Key Duties and Responsibilities:
* Provides on-going completion of Consultant clinical documentation to ensure timely claim form submissions within agreed target guidelines.
* Completion of supporting consultant documentation to ensure billing is completed accurately and in line with consultant contract.
* Review part paid claims and completion of appeal letters where claim has not been paid in full.
* Develop relationships with consultants, hospital departments, including IT to identify potential improvement opportunities.
* Establish and maintain review meetings with Consultants or their supporting staff to discuss and improve KPIs, denial trending and any documentation issues.
* Communicates in a way that promotes trust and credibility between the revenue cycle functional teams and consultants and hospital leadership and strives to strengthen local and facility relationships for positive outcomes.
* Develop and maintain relationships with NTPF Co-ordinator, NTPF, referring hospitals liaison offices and Consultant medical staff and their secretaries.
* Assist the NTPF coordinator with the interpretation of clinical referral data and advise the co-ordinator on the appropriate referral pathways.
* Assist the NTPF co-ordinator with the description and definition of outliers and provide advice on the clinical justification of same.

Essential:
* Qualified RGN
* 3-5 years general nursing experience

Desirable Experience
* 3-5 years’ experience in Hospital billing, Consultant billing, or Insurer claims processing.

Essential Skills
* Excellent communication skills with clear presentation and reporting ability
* Strong and demonstrated analytical and problem-solving abilities
* Demonstrated proficiency Microsoft Excel, and other Microsoft Office Suite applications.
* Service-oriented and proactive team player
* Ability to develop strong co-operative working relationships
* Able to motivate and challenge team members

Excellent Salary & benefits for the right candidate
For more information & full job spec Please Call Maria O’ Dwyer to on 087 2951493 for a confidential chat & please email your full CV as a word attachment to md@headhuntinternational.com

Keywords: Staff Nurse, Nurse, Clinical Nurse Manager, CNM, Dublin, Hospital,Claims Utilisation Nurse