This is a per diem day shift position. Internal Candidates Only.

We’re a nonprofit, regional healthcare network with two hospitals, numerous outpatient medical offices, a multi-specialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer and emergency services. Our leadership is dedicated to putting patients first—a cornerstone of our mission, vision and values—as we deliver top-quality healthcare.

From our extensive facilities in Whittier, California and Downey, California, PIH Health serves more than two million residents in Los Angeles and Orange Counties and throughout the San Gabriel Valley.

This position, reporting to the Vice President of Revenue Cycle, is responsible for the management of clinical denials at both the Whittier and Downey campuses, including timely submission of appeals as required by payer and regulatory requirements, root cause identification, education and training of case managers and physicians on denial prevention techniques, and the implementation of denial prevention workflows and processes across the IDS.

Required Skills

• Excellent verbal, written, and organizational skills required
• Knowledge of medical terminology and current third party payor reimbursement methodologies
• Ability to follow chain of command
• Self-motivated, proactive, and results oriented
• Must be able to demonstrate sound decision making and prioritization skills, utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant others when administering or explaining care.

Required Experience

• Must maintain an active California RN license.
• Must have a minimum two (2) years of acute hospital experience.
• Managed care and case management experience preferred.
• Proficiency with main-frame and personal computers.

Beyond the benefits that come with working for the area's leading community healthcare provider – one that also recognizes the need to ensure patient safety and comfort – you'll enjoy an extremely competitive compensation and benefits package.  We are an equal opportunity employer and seek diversity in our workforce.   EOE M/F/D/V

• Excellent verbal, written, and organizational skills required
• Knowledge of medical terminology and current third party payor reimbursement methodologies
• Ability to follow chain of command
• Self-motivated, proactive, and results oriented
• Must be able to demonstrate sound decision making and prioritization skills, utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant others when administering or explaining care.