Description
Provide consultation and guidance regarding admissions and patient length of stays to a variety of payers.
Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations through ongoing clinical reviews until patient discharges from treatment.
Evaluate the utilization operations for compliance with mandatory policies and procedures.
Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
Maintain efficient, positive customer service attitude towards customers, clients and co-workers while being responsive to
May provide oversight and direction to utilization staff.
Qualifications
Education
Preferred
Experience
Preferred
- 2-5 years: Utilization Review
