SALARY / 8:00am - 5:00pm / with on-call, weekend, & holiday rotation required;
JOB REQUIREMENTS
EDUCATION
Minimum: Graduate of accredited school of nursing (BSN Preferred)
Preferred: Bachelors Degree in Nursing with case management certification
LICENSE/CERTIFICATION
Licensed RN in State of Indiana. Certification plan in place within 24 months of hire.
EXPERIENCE
Minimum: 2-3 years of acute care clinical experience
Preferred: 3-5 years of acute care clinical experience with strong knowledge of medical necessity criter and payer requirements
JOB DUTIES
1. Utilization Review and Medical Necessity
2. Concurrent Review and Length of Stay Management
3. Retrospective Review
4. Payer Communication & Authorization
5. Denials Management and Appeals