Utilization Review Generalist / Utilization Review / PRN

Summary of Performance Expectations

Performs a variety of administrative office duties to include: management and organization of confidential materials and records; providing support services as assigned; collecting and reporting data, information and analyses, coordinating internal and external functions and reporting requirements of the Utilization Review department. Meets with patient or representative to discuss discharge appeal process.

Education and Credentials:

Required:

High School Diploma. Office Systems Technology or business/accounting related field.

Preferred:

Formal training in basic computer applications.

Work Experience:

Required:

Two years experience in a healthcare facility with focus on customer service, utilization of MS Office applications and confidential records management. Electronic Health Record (EHR) experience. Ability to exercise independent problem solving and goal setting skills. Given training and on-the-job experience, incumbent should be proficient in the basic aspects of the job within three months of employment date.

Preferred:

Knowledge of medical terminology and a clear understanding of basic ICD and CPT codes. RHIT certification. Experience with Meditech.