RN Utilization Review

As our Utilization Review RN, you will meticulously review medical records to confirm appropriate admission status and continued hospitalization, utilizing established criteria and critical thinking. You'll work hand-in-hand with Concurrent Denial RNs to identify the root causes of denials and implement proactive prevention strategies. This role is essential for collaborating with Patient Access to verify payer sources, documenting interactions, and obtaining inpatient authorization from insurance providers, ensuring seamless patient journeys and financial integrity. Every day you will conduct admission, concurrent, and post-discharge reviews, ensuring...