• RN Global Contract Facilitation

    Posted Date 1 week ago(1/10/2019 5:48 PM)
    Requisition ID
    2018-45593
    Category
    Nursing - Admin/Education
    Position Type
    Regular Full-Time
    Department
    ICE CORE ICF Hosp Billing Quality Assurs
    Shift
    Day Shift
    Post End Date
    1/25/2019
  • Overview

    Schedule: Full-Time, 8:00am-4:30pm

     

    Registered Nurse Global Contract Facilitator duties include managing global contract facilitation, including, but not limited to, identifying global accounts, reviewing bills, identifying carve-outs, tracking all phases of the contracted transplant episode and maintaining Global Database.   Assists with the identification and development of process improvement strategies relative to global contract administration.   Appeals denied claims.  Educates staff on the interpretation of global contracts and informs them of updates to those contracts.  Prepares reports for information and analysis.

     

    The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork and diversity.  We champion being a collaborative health care organization, focused on improving patient care and the lives of Arkansans.  

     

    UAMS offers amazing benefits and perks:

    • Health: Medical, Dental and Vision plans available for staff and family
    • Holiday, Vacation and Sick Leave
    • Education discount for staff and dependents (undergraduate only)
    • Retirement: Up to 10% matched contribution from UAMS
    • Basic Life Insurance up to $50,000
    • Career Training and Educational Opportunities
    • Merchant Discounts
    • Concierge prescription delivery on the main campus when using UAMS pharmacy.

    Responsibilities

    The RN Global Contract Facilitator administers global contracts through identification of global patients, review of patient bills, both hospital and physician.  Identifies carve-outs to increase reimbursement. Tracks all phases of the contracted transplant episode.  Works closely with the Manage Care office, makes recommendations for revisions and updates to new and existing global contracts.  Coordinates the appeal of claims not paid according to contract terms or denied. Works closely with the representatives of global networks and contracts to ensure global dates are set up correctly and to ensure correct and prompt payments.  Acts as a liaison for HBS, MCPG and MIRT Case Management.  Maintains statistical data for global patients by maintaining Global Database.  Assists in the collection and assessment of charge, reimbursement and utilization data.  Provides data to the Managed Care Office, ACRC, MCPG, Hospital Administration and others as defined or requested. Ensures medical necessity of BMT facility and physician billing is supported in documentation by providing training to staff on BMT specific coding and documentation changes and updates driven by global contract payers.  Assists clinic personnel on proper documentation.

    Qualifications

    Required:

    • Bachelors Degree in Nursing
    • Current RN License
    • Minimum of 1 year RN expierience in oncology clinical operations of bone marrow transplant.
    • Minimum of 2 years experience in Revenue cycle managed care, patient billing, insurance or case management
    • 1 year of EPIC experience.
    • Must be proficient on the computer
    • Must be able to make decisions regarding the appropriateness of charges as supported by review and interpretation of medical record documentation. 
    • Must be able to decide the course of action appropriate for the appeal of denied claims.

    Preferred: 

    • 2 or more years of RN expierience in oncology clinical operations of bone marrow transplant.
    • 3 or more years experience in Revenue cycle managed care, patient billing, insurance or case management
    • 2 or more years of EPIC experience.

    This position is subject to a pre-employment criminal background [and registry (if applicable)] check [and drug screen (if safety sensitive position)].  A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant. Any criminal history will be evaluated in relationship to job responsibilities and business necessity.  The information obtained in these reports will be used in a confidential, non-discriminatory manner consistent with state and federal law. 

     

    UAMS is an Affirmative Action and Equal Opportunity Employer of individuals with disabilities and protected veterans and is committed to excellence.

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