RN Case Management

Is RN Case Management Right for You?

If you’re exploring a career in RN case management, it’s important to first determine how equipped you are to handle the many moving parts of revenue cycle management. At most healthcare facilities, RN case managers play a major role in the revenue cycle in all phases of patient care. As an RN case manager, your work will be heavily integrated with revenue cycle management to improve efficiency by reducing denials, streamlining admissions and discharge processes.

Here are two of the vital ways in which you’ll contribute to a facility’s revenue cycle success:

  1. Patient flow process. By being involved in the different phases of patient care, you’ll have a direct impact on how patient billing procedures are handled throughout care, from pre-admission to post-discharge. The way in which patients are classified in each stage will affect every aspect of the billing process, including reimbursement, denials and insurance contracts. Throughout patient care, it’s the responsibility of RN case managers to serve as a liaison between insurance payers and hospitals to ensure proper reimbursement. You’ll also need to establish fluid communication with all administrative departments involved in the billing cycle to provide updates and clarification to reduce the risk of claim denials.
  2. Opportunities for improvement. Working closely with your facility’s financial leadership team means you’ll be expected for things like sharing regular data from the trajectory of patient care. In addition, you’ll be responsible for identifying opportunities in several areas such as cost per case, length of stay and inpatient delays. Proactively identifying opportunities for improvement can significantly improve revenue cycle efficiency, reduce the incidence of denials and create a more accurate billing process to improve the overall operation of your facility.

As you can see, RN case managers are integral to the revenue cycle process at any healthcare organization. Acclimating yourself with revenue cycle responsibilities will prepare you for success in a case management role and allow you to make impactful contributions to your organization.

Do you have what it takes to excel as an RN case manager? If you’re in search of new positions, get in touch and explore new employment opportunities with AMN Healthcare.