Summary
The Utilization/Admission Review Coordinator promotes an effective continuum of care for the patient through intra- and interdepartmental utilization practices and coordination. Works with other departments to develop and maintain an effective integration of the revenue cycle functions to maximize reimbursement.
Minimum Education
* Graduate of an accredited school of nursing with BSN, preferred.
Minimum Work Experience
* 5 Years medical/surgical experience.
* Strong background in utilization management principles, concepts, and strategies, including admission criteria, observation, levels of care, and denials.
Required Licenses/Certifications
* Licensed in the State of Vermont.
* CPR Certification*
*Must obtain within 3 months of hire
Required Skills, Knowledge, and Abilities
* Excellent verbal and written communication skills.
* Demonstrated strong knowledge of basic computer skills.
* Skill with database management functionality.
* Understanding of commercial insurances, Medicare, Medicaid, and State/Federal regulatory frameworks that impact utilization.
* Strong working knowledge of insurance and regulatory terminology.
* Proven critical thinking and analytical skills.
* Strong organizational skills.
* Prior demonstration of attention to detail.
* Willingness and ability to participate in weekend coverage rotation.
Pay Range = $ $63.60
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