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LPN Utilization Management Reviewer - Case Management - Full Time

Company

Guthrie

Location

Cortland, United States

Type

Full-time

This position is eligible for up to $15,000.00 Sign on Bonus for those that are eligible. ($7,500.00 for those with less than one year of experience)
Summary

The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert Packer Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior authorization/certification for reimbursement of patient care services. The responsibilities include:

+ Facilitating communication between physician offices, payers, Care Coordination and other hospital departments as appropriate to obtain prior authorization required to meet contractual reimbursement requirements and to assist in ensuring generation of clean claims in a timely manner

+ Securing authorization as appropriate

+ Documenting payer authorization

+ Facilitating issue resolution w...

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