Guthrie

Nurse

• Provide professional nursing care for acute care patients using telecommunication technology
• Provide virtual support to bedside nurses at Guthrie Hospital inpatient acute care units
• Collaborate with bedside nurses to deliver coordinated, safe, compassionate, therapeutic, evidence-based care
• Monitor patients using clinical assessment, EPIC and Sickbay or designated software, videoconferencing, proactive surveillance, chart review, and clinical alarms
• Assess patients and address subtle signs of clinical deterioration or status changes
• Develop, update, and coordinate patient care plans to optimize outcomes and transitions
• Monitor, record, and communicate patient condition
• Advocate for ethical and holistic care and support patient autonomy, dignity, rights, values, and beliefs
• Inform, coach, and support onsite nurses and clinicians
• Facilitate formal and informal learning for patients, families, nurses, healthcare team members, students, and the community
• Serve as a clinical resource and coach and mentor clinical nurses
• Manage assignments involving complex patients and unit demands
• Respond to routine, urgent, and emergent patient situations and provide follow-up for resolution
• Engage in professional development and promote research and evidence-based practice
• Provide leadership and contribute knowledge of pathophysiology, pharmacology, hemodynamics, bedside technology, and nursing care
• Perform other duties as assigned

Acute Care Registered Nurse – Full Time, Evenings

• Provide virtual professional nursing care for patients in acute care environments using telecommunication technology
• Provide virtual support to bedside nurses at Guthrie Hospital inpatient acute care units
• Collaborate with bedside nurses to deliver coordinated, safe, compassionate, therapeutic, evidence-based care
• Use clinical assessment skills, EPIC, Sickbay, or designated software to monitor patients
• Assess subtle signs and symptoms of clinical deterioration or status changes and address them proactively
• Develop, update, and coordinate patient care plans
• Monitor, record, and communicate patient conditions
• Advocate for ethical, holistic care and patient autonomy, dignity, rights, values, and beliefs
• Inform, coach, and support onsite nurses and clinicians
• Facilitate learning for patients, families, nurses, healthcare team members, and students
• Serve as a clinical resource and coach and mentor clinical nurses
• Manage complex patient assignments and unit demands
• Respond to routine, urgent, and emergent situations through videoconferencing, surveillance, chart review, and clinical alarms
• Provide follow-up to ensure problem resolution
• Engage in professional development and evidence-based practice
• Demonstrate leadership as a change agent through advocacy, influence, and innovation
• Contribute expertise in pathophysiology, pharmacology, hemodynamics, bedside technology, and nursing care
• Perform other duties as assigned

Virtual Acute Care Registered Nurse

Insurance

• Serve as a group leader and resource specialist within the department
• Participate in staffing and employment issues
• Train Insurance Billing Specialists I and related support staff
• Work with the Director, Manager, Supervisor, and Application Analyst on daily priorities and unit integrity
• Complete complex insurance billings and appeals
• Review insurance processing procedures and recommend streamlined processes
• Prepare required and requested reports
• Work with insurance payers on problem claims and processes
• Resolve outstanding Accounts Receivable and credit balances
• Identify and evaluate denials, determine issues and patterns, and participate in Denial Task Forces
• Export data, prepare spreadsheets, and create and run reports for outstanding claims
• Analyze complex billing problems, prepare appeals, challenge payer policies, and pursue appeal turnover
• Develop and train internal rejection protocols
• Audit and educate staff on protocol adherence
• Report payer, system, or billing issues and recommend resolutions
• Resolve credit balances and assist with annual escheatment documentation
• Lead payer-specific external claim audit activity with management, compliance, medical records, and clinical operations
• Route work assignments and participate in employment issues
• Review requested adjustments and approve low-dollar adjustments within policy; gather documentation for high-dollar adjustments
• Test and monitor new system logic or processes
• Answer phone calls and correspondence regarding account balances
• Provide workflow feedback to promote efficiency
• Use Epic functions for charge corrections, invoice inquiry, credits, charge review, claim edits, and 277 rejections
• Demonstrate excellent customer service and promote it within the team
• Complete projects and other assigned duties

Insurance Specialist II – Corporate Patient AR Management

• Submit non-complex electronic and paper claims to insurance payers
• Coordinate information for secondary and tertiary claims reviews
• Analyze claims for accurate and compatible diagnosis and procedure codes
• Make charge corrections and follow up with appropriate parties to ensure billing invoices are correct
• Follow up with payers on unresponded, rejected, and denied claims
• Work denied claims according to coding and payer guidelines, resulting in appeals or charge corrections
• Collaborate with Insurance Billing Specialist II and Denial Resolution staff on projects, complex billing issues, cross-training, and payer tasks
• Respond to questions from insurance companies, government agencies, and Guthrie Medical Group offices
• Partner with CRC and other Guthrie departments on billing inquiries
• Respond to insurance carrier correspondence and requests for supporting documentation
• Work pre-AR edits, paper claims, reports, and work queues for accurate and timely claim submission
• Provide backup to Central Charge Entry and Cash Applications, including entering charges and posting/distributing payments
• Report payer, system, or billing issues
• Use Epic functions for charge corrections, invoice inquiries, billing edits, and insurance eligibility
• Export and prepare spreadsheets for project work
• Resolve credit balances and request/document invoice adjustments within policy guidelines
• Provide workflow feedback, answer calls and correspondence, document actions, and complete assigned projects

Acute Care Registered Nurse – Full Time, Evenings

Virtual Acute Care Registered Nurse

Insurance Specialist II – Corporate Patient AR Management

Insurance Specialist I – Corporate Patient AR Management