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West River Health Services

Utilization Review Specialist

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What they do

A Clinical Documentation Specialist works with information technology systems and applications in health care organizations. Assists clinicians and staff with technology and implementing new systems. Creates systems for organizing and interpreting data and information for clinical trials. Records and manages clinical information about patients, including health assessments and diagnoses, test results, treatments, and follow up care requirements. Reviews and maintains patient records.

$78,140 / year median in North Dakota

-3% projected decline

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Job Description

West River Health Services is a mission-driven Critical Access Hospital and Rural Health Clinic serving the residents of southwestern North Dakota. Guided by our core values of Excellence, Innovation, Compassion, and Respect, we're committed to providing the kind of quality health care typically found in larger cities, delivered with small-town friendliness and individual care. We believe our employees are the foundation of that commitment, working together to deliver safe, high-quality, patient-centered care. Job Summary Under the direct supervision of the HIM Manager, monitors utilization of resources, risk management, and quality of care for patients per established guidelines, collecting clinical information for payer authorization. Key Responsibilities Perform preadmission and retrospective chart reviews Coordinate with discharge planning on medical necessity and level of service Obtain preauthorization, precertification, and length-of-stay extensions Review hospital records daily for appropriate care environment placement Required LPN license or RHIT credential (coding certifications also acceptable:
CCS, CCS-P, CPC, CPC-H
) 3 years relevant experience; minimum 1 year healthcare/clinical experience West River Health Services is an Equal Opportunity Employer.