Job Detail

Job Title:

Case Manager (UR)

Department:

Utilization Review

Full/Part Time:

Full

Req Number:

UHS-36304

Position Summary:

Reviews surgical cases for coding and compares to Medicare's Inpatient Only List. Compares prior authorizations against surgery performed to ensure accurate CPT codes applies to authorization. Collaborates with physicians and obtains status adjustment orders when necessary. Utilizes Code 44 process as appropriate and applies to claims per CMS guidelines.

Position Qualification:

RN in state of TN. BSN preferred Utilization Review experience or coding experience preferred.