Ability to work in changing environment
Ability to prioritize independently and respond to multiple simultaneous requests
Ability to work under stressful conditions and in difficult situations
May require carrying approximately 8 pound laptop to nursing unit(s)
Prolonged periods at computer in an office environment
Responsible for determining the correct level of care.
Serves as a liaison between the facility and external payers on issues related to severity of illness and intensity of service.
Conducts performance improvement activities to improve utilization of facility resources.
Monitors patient care to ensures appropriate utilization of hospital services.
Accountabilities:
Performs medical record reviews for severity of illness and intensity of service.
Responsible for development and professional practice.
Provides back~up coverage for the Denials Coordinator position.
Interacts with external review agencies to insure compliance with regulations affecting financial reimbursement to the facility.
Conducts performance improvement activities to improve utilization of services and resources.
Provides assistance with and also completes own monthly reporting as needed by facility.
Others as assigned
Current State Licensure
BLS
3 years experience (1in UM)
All your information will be kept confidential according to EEO guidelines.
Job details are sourced from the employer's original posting.
Open job posting