Medical Records - Tulsa, OK, United States - Saint Francis Health System

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    Full time
    Description
    Saint Francis Health System is seeking a LPN / LVN for a job in Tulsa, Oklahoma.


    Start Date:

    ASAP

    Employment Type:
    Staff

    Full Time

    Hours:
    Monday - Friday | 11:00pm - 7:00am


    Job Summary:

    The Utilization Management Specialist (LPN) will analyze patient records to determine legitimacy of hospital admission, treatment, and appropriate level of care.

    This position will leverage the algorithmic logic of the UM software to utilizing key clinical data points to assist in status and level of care recommendations.

    Completion of a state approved Licensed Practical Nurse program or registered nurse coursework approved by the Board of Nursing as practical nurse equivalency.

    Bachelor of Science in Nursing or other related field, preferred.

    Licensure, Registration and/or Certification:

    Work Experience:
    Minimum 3 years of related experience in an acute care setting. Experience working in electronic health records, preferred.
    Demonstrated ability to integrate the analysis of data to discover facts or develop knowledge, concepts, or interpretations. Ability to be detail oriented as required in the examination of numerical data. Strong analytical and data management knowledge. Working knowledge of Microsoft Word, Excel and Access in the preparation of correspondence and reports.

    Performs pre-admission status recommendation in Emergency Department or elective procedure settings as assigned, to communicate with providers status guidance based on available information.

    Maintains thorough knowledge of payer guidelines, familiarity with payer processes for initiating authorizations, and following through accordingly to prevent loss of reimbursement, including the management of concurrent and pre-bill denials.

    Ensures all benefits, authorization requirements, and collection notes are obtained and clearly documented on accounts in the pursuit of timely reimbursement within established timeframes to avoid denials.

    Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate management of claims.

    Works with internal customers via telephone or face to face interaction. Works with other healthcare professionals and staff.


    Supplemental Information:

    This document generally describes the essential functions of the job and the physical demands required to perform the job.

    EOE Protected Veterans/Disability
    Saint Francis Healthcare System Tulsa Job ID #JR13040. Utilization Management Specialist (Lpn): Monday - Friday | 11P - 7A (Overnights)
    About Saint Francis Health System

    Saint Francis Health System is a Catholic, not-for-profit health system wholly owned and operated in Tulsa, Oklahoma whose mission is to extend the presence and healing ministry of Christ to all who seek its services.

    The health system is anchored by Saint Francis Hospital, a 1,112-bed tertiary center, which includes the region's only children's hospital and level IV neonatal intensive care unit, a 168-bed heart hospital and Tulsa's leading trauma and emergency center.

    Additionally, Saint Francis employs more than 450 providers through Warren Clinic, which serves the region with more than 95 locations throughout eastern Oklahoma.

    In total, the organization has more than 11,500 employees, 1,000 physicians and 700 volunteers, making it the largest private employer in Tulsa County.

    Holiday Pay
    ~ 401k retirement plan
    ~ Employee assistance programs
    ~ Medical benefits
    ~ Dental benefits