In a career at Boys Town National Research Hospital, you join us in changing the way America cares for children and families. We are currently expanding services. Come grow with us!
Reviews the appropriateness of patient status for all admissions to BTNRH utilizing approved inpatient care criteria guidelines (InterQual, Millian).
Documents all discharge, assessments of appropriateness of Inpatient or Observation status, and all other UR activities performed on a concurrent basis in Next Gen Financials, trending data and issues. Communicates findings to immediate supervisor and/or others as requested.
Provides relevant clinical information to insurance companies as required to obtain certification numbers and approved days with documentation on worksheet to comply with necessary requirements for appropriate reimbursement.
Performs routine and impromptu charge audits as directed by the Administrative team, leadership or through the patient concern/dispute process, to ensure billed charges are supported within the clinical documentation, as well as to identify missing or over-stated charges on the account &/or claim form and communicating results back to the appropriate party(s).
Registered nurse who is a graduate of an accredited school with a current state license.
Bachelor's degree in Nursing, preferred.
Knowledge of pediatric/adult nursing clinical practice, compliance and/or medical auditing, coding, utilization review, and/or other related healthcare experience, required.
Minimum of five years experience involving decision-making with knowledge of utilization review activities, applying InterQual and/or Milliman criteria, preferred.
Must have good communication, assessment, and organizational skills.
Must have good PC skills, including experience with Microsoft Outlook, Word, and Excel.
Must have good public relation skills and be detail oriented.
Background in Medicare, Medicaid, third-party billing, compliance and reimbursement regulations, preferred.
Must be CPR certified.
Must have experience with billing and EMR software applications as they apply to the computerized patient record.
About Boys Town National Research Hospital:
Boys Town National Research Hospital offers a broad range of hospital and clinic services, backed by 40 years of life-changing research to provide the latest, most innovative care to our patients. From pediatric inpatient hospitalization and surgical services, to outpatient visits, to residential care for children and adolescents with severe behavioral disorders, our board certified specialists and highly trained pediatric nurses’ focus on caring for the unique needs of children and their families. Boys Town National Research Hospital is a license acute care hospital and psychiatric residential treatment facility and accredited by The Joint Commission. Boys Town National Research Hospital is part of Boys Town, which has been committed to the care of children for over 100 years.
Our employees are our #1 supporters when it comes to achieving Boys Town’s mission, which is why we offer an array of competitive and attractive benefit options. Unique perks to Boys Town employees and their families include free visits to Boys Town Physicians, free prescriptions, tuition assistance, access to the campus Field House, parenting resources from our expects and advancement opportunities within the organization, just to name a few. Working at Boys Town is more than just a job; it is a way of life.
Date Posted: 8/29/2019
Job ID: 14193
Boys Town National Research Hospital is a tobacco free campus. This advertisement describes the general nature of work to be performed and does not include an exhaustive list of duties, skills, or abilities required. Boys Town is an equal employment opportunity employer and participates in the E-Verify program. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. To request a disability-related accommodation in the application process, contact us at 1-877-639-6003.
Internal Number: 011885
About Boys Town National Research Hospital
Since the opening of Boys Town National Research Hospital in 1977, the hospital has been internationally recognized as a leader in clinical and research programs focusing on childhood deafness, visual impairment and related communication disorders. We have developed national medical programs that are now instituted in hospitals and clinics across the country.
Today, the hospital offers a broad range of clinical services, including ear, nose and throat services at the Boys Town Ear, Nose and Throat Institute, general pediatric care with Boys Town Pediatrics, and orthopaedic, internal medicine, pediatric gastroenterology, allergy, asthma, pediatric pulmonology, behavioral health, audiological and ophthalmologic care.
The hospital has expanded to offer surgical and clinical services at two Omaha locations: 555 North 30th Street in Omaha and 14000 Hospital Road on the campus of Boys Town, Nebraska.
Boys Town National Research Hospital has assembled national leaders in research who are making important contributions in the areas of genetics, hearing, language, vision and speech disorders. Applying these findings with new technologies, distance learning and the exploration of ne...w research frontiers, the opportunities for new medical diagnoses, evaluation and treatment discoveries are endless.
Accredited by The Joint Commission, Boys Town National Research Hospital is dedicated to providing leading edge clinical care, pioneering translational research and improving the lives of children and their families through applied technology and educational outreach programs. The hospital annually serves more than 40,000 children and families from across the United States.