Clinical Review Nurse - Patient Financial Services - 00066

Phoenix Childrens Hospital is the only specialty childrens hospital in Arizona and it is poised to become one of the foremost pediatric hospitals in the nation. The hospital is home to the states largest group of pediatric specialists and sub-specialists. In addition, the hospital continues to evolve its clinical practices and is working with leading local and national research partners to uncover new breakthroughs in pediatric medicine. Currently a 299 bed facility, new construction plans were unveiled in October 2006 that include the building of two new patient bed towers and expansion in bed capacity and other key programs and services over the course of the next several years. In short, PCH is a growing, thriving organization where opportunities for personal development and promotion of our employees will continue in years to come. Primary Purpose: Collaborates with Case Management staff, Admitting Financial Counselors, physicians and Admitting Dept. staff to facilitate, assist, and ensure reimbursement from third party payors through daily thorough and comprehensive review of all accounts that require clinical documentation and/or intervention by a board certified clinician. Reviews federal Section 1011 cases for stabilization requirements and assists with denial management processes. Work Environment: Activities are performed in an environmentally controlled office area subject to long periods of sitting, standing and walking; may be required to bend, reach, lift, pull and push up to 20 pounds; regularly experiences frequent interruptions, high stress levels, changing priorities and distractions associated with working with multiple patient accounts and third party payors. Ability to clearly communicate in English, read, write, see and hear to perform essential duties. CB Qualifications Minimum Qualifications: 1. Current State of Arizona RN license2. Must have at least 5 years clinical review nursing experience with a Bachelors degree in Nursing or closely related field preferred3. Knowledge of and understanding of HIPAA privacy laws.4. Working knowledge of managed care programs, enrollment, operations, DES, State and Federal Medicaid programs, Basic Health Plans and Social Security disability systems preferred.5. Analytical skills with strong attention to detail and a high degree of accuracy in reviewing and assessing accounts on a daily basis.6. Strong English communication and comprehension skills; bilingual Spanish preferred.7. Ability to work and meet deadlines in a fast-paced environment with frequently changing priorities with minimal supervision.CB Job Title: Clinical Review Nurse - Patient Financial Services - 00066 Location: Phoenix, AZ 85001 Status: Full Time, Employee Reference ID: 13320 When you join us, you'll enjoy great benefits: Relocation Assistance Tuition Reimbursement Paid Time Off 401(k) Employee Assistance Program Medical/Dental/Vision/Life/Disability/Pet Insurance Flexible Spending Accounts Child Care Discounts Computer Discounts Fitness Center Discounts To learn how you can make a difference in a child's life or to apply online, visit our web site at www.PhoenixChildrens.com/employment