Job Overview We are seeking a highly motivated and detail-oriented Certified MobilePRO Advocate to join our dynamic healthcare team. In this role, you will serve as a vital link in the utilization review and management process, leveraging your expertise in medical coding, clinical documentation, and patient care coordination. Your energetic approach will help streamline patient services, ensure compliance with healthcare regulations, and support optimal patient outcomes across diverse medical settings. This position offers an exciting opportunity to make a meaningful impact by advocating for quality care and efficient resource utilization. Duties Conduct comprehensive utilization reviews for various hospital departments, including ICU, emergency medicine, pediatrics, and trauma centers, ensuring appropriate patient care and resource allocation Apply advanced knowledge of CPT coding, ICD-9, ICD-10, and ICD coding systems to accurately review medical records and documentation Collaborate with healthcare providers, social workers, case managers, and discharge planners to facilitate seamless patient transitions and discharge planning processes Assist in managing compliance with HIPAA regulations and maintain strict confidentiality of patient information within EMR/EHR systems Support managed care initiatives by evaluating medical necessity and supporting utilization management efforts across diverse clinical settings Communicate effectively with patients, families, and healthcare teams to clarify medical documentation requirements and provide guidance on social services or behavioral health needs Utilize Microsoft Office tools to document findings, prepare reports, and track case progress efficiently Requirements Proven experience in critical care, hospital medicine, or emergency medicine environments with a strong understanding of acute care procedures Extensive knowledge of medical terminology, CPT coding, ICD-9/10 coding systems, and utilization review processes Experience working within Level I or Level II trauma centers or PICU settings is highly desirable Familiarity with EMR/EHR systems and healthcare compliance standards such as HIPAA is essential Background in social work or behavioral health services is a plus; bilingual skills are advantageous for working with diverse populations Strong communication skills with the ability to collaborate effectively across multidisciplinary teams Demonstrated ability to manage case loads efficiently while maintaining attention to detail in documentation and reporting Knowledge of health insurance policies, discharge planning procedures, and managed care operations is preferred Join us as a Certified MobilePRO Advocate to champion quality patient care through expert utilization management! Your dedication will help ensure that patients receive the right care at the right time while supporting healthcare providers in delivering excellence. We are committed to fostering an inclusive environment where your skills can thrive—apply today to be part of our passionate team!

Pay:

$400.00 - $700.00 per hour Expected hours: 20.0 per week

Benefits:

Employee assistance program Flexible schedule Referral program

Work Location:

In person