NTPF and Claims Utilisation Nurse page is loaded
NTPF and Claims Utilisation Nurse
Job Title: Fixed Term Part time CNM1 NTPF and Claims Utilisation Nurse
Reports to: Director of Nursing / Head of Finance
Location: Bon Secours Hospital Dublin
Job Purpose: The fundamental philosophy guiding this position will be to promote and preserve the Bon Secours mission, values (Human Dignity, Integrity, Compassion, Stewardship & Service) and ethos by effective delivery of mission objectives in your capacity as NTPF and Claims Utilisation Nurse.
Key Duties and Responsibilities:
* Promotes and preserves the Bon Secours Mission, Values & Ethos.
* Provides ongoing completion of Consultant clinical documentation to ensure timely claim form submissions within agreed target guidelines.
* Completion of supporting consultant documentation to ensure billing is completed accurately and in line with consultant contract.
* Review part paid claims and completion of appeal letters where claim has not been paid in full.
* Develop relationships with consultants and hospital departments, including IT, to identify potential improvement opportunities.
* Establish and maintain review meetings with Consultants or their supporting staff to discuss and improve KPIs, denial trending, and any documentation issues.
* Communicates in a way that promotes trust and credibility between the revenue cycle functional teams and consultants and hospital leadership and strives to strengthen local and facility relationships for positive outcomes.
* Develop and maintain relationships with NTPF Co-ordinator, NTPF, referring hospitals liaison offices, and Consultant medical staff and their secretaries.
* Assist the NTPF coordinator with the interpretation of clinical referral data and advise the co-ordinator on the appropriate referral pathways.
* Assist the NTPF co-ordinator with the description and definition of outliers and provide advice on the clinical justification of same.
* In liaison with the BSHD Finance Department, assist the NTPF Co-ordinator and Administrative Team in the collation of NTPF discharge summaries and hospital accounts for submission to NTPF.
* Assist the NTPF co-ordinator and Administrative Team in patient bookings and the full and accurate completion of NTPF discharge summaries.
* Following up with consultants regarding outstanding discharge summaries and delayed discharge summaries generated for referring hospitals.
* Escalates issues to direct leader as necessary to ensure timely resolution.
* Promote and participate in the implementation of change.
* Strong teamwork skills including the ability to build and maintain relationships with a wide range of internal and external stakeholders.
* Ability to prioritize work and effectively handle multiple tasks and see these through to completion.
* To ensure that all contact with patients, GP’s, Consultants, staff, and visitors is courteous and professional at all times.
Essential Qualifications:
* Leaving Certificate or equivalent
* RGN qualification
Desirable Qualifications:
* Higher Diploma in business or related subject
Essential Experience:
* 3-5 years general nursing experience
Desirable Experience:
* 3-5 years’ experience in Hospital billing, Consultant billing, or Insurer claims processing.
Essential Skills:
* Excellent communication skills with clear presentation and reporting ability
* Strong and demonstrated analytical and problem-solving abilities
* Demonstrated proficiency in Microsoft Excel and other Microsoft Office Suite applications.
* Service-oriented and proactive team player
* Ability to develop strong cooperative working relationships
* Able to motivate and challenge team members
CLOSING DATE FOR RECEIPT OF APPLICATIONS: 15TH NOVEMBER 2024
BON SECOURS HOSPITAL IS AN EQUAL OPPORTUNITIES EMPLOYER
About us
As Ireland’s largest independent hospital group, Bon Secours Health System CLG (Registered Charity No.20027841) is renowned for the quality of its service provision coupled with a rich tradition in healthcare. Bon Secours Health System CLG is a not for profit organisation with its mission centred on providing compassionate, world-class medical treatment to all those it serves. With 3,000 staff, 450 leading consultants, Bon Secours treats in excess of 280,000 patients annually in its 5 modern acute hospitals in Cork, Galway, Limerick, Tralee, and Dublin as well as a Care Village in Cork. It is one of the largest providers of private healthcare in Ireland.
Bon Secours Health System is internationally accredited by the Joint Commission International Accreditation Standards for Hospital (JCI), the leading organisation in the international accreditation of hospitals for quality and patient safety.
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