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Utilization Review Specialist
Job
Sharon Regional Health System
Sharon, PA (In Person)
Full-Time
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Job Description
We are seeking a Utilization Review Specialist to join our healthcare team. The Utilization Review Specialist ensures that the appropriate authorization for treatment is secured, and that all pertinent clinical information is present to obtain this authorization. The UR Specialist works with the medical staff and the other members of the interdisciplinary team to assist in the delivery of quality care across the continuum. Planning for individual age-specific needs will occur as it relates to the assigned patient population. Documentation requirements are monitored by the UR Specialist. Responsibilities Secures authorization for payment of services rendered from all types of primary and secondary insurers. Maintains knowledge of coding and diagnostic standards to ensure appropriate service utilization. Ensures the thoroughness of all documentation entered into the medical record. Additional duties to be discussed. Qualifications Valid Registered Nurse (RN) license in the state of practice. Bachelor's degree preferred. Minimum of 2 years' experience. Familiarity with HIPAA regulations and patient confidentiality protocols. Excellent communication skills, both verbal and written. Demonstrated leadership and organizational skills. Join our team of healthcare professionals dedicated to making a difference in the lives of our patients!