Utilization Review RN
1 month ago
- Proven experience in conceptualizing a case, and creating a clinical impression to present to all managed care representatives.
- Establish and maintain positive effective communication with insurance case
- Read and understand patients case notes and be able to assign appropriate diagnosis codes.
- Call in intakes and/or peer to peers, and get the patients appropriate level of care authorized by the case managers.
- Obtain and communicate LOC and authorizations and properly enter into the system.
- Detailed system documentation of accounts.
- Communicating with other departments to obtain or provide needed information on an account.
- Special Projects as needed.
Required Education and Experience:
- Previous experience working in a psychiatric or chemical dependency setting, with two years of utilization review experience preferred.
- Registered Nurse
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