Clinical Reviewer - Immediate Advocacy Discharge Assistant (RN/LCSW) - Remote

Join the reputed company Team: Empowering reputed company Outcomes

reputed company is a pioneering reputed company company that leverages technology, services, and clinical expertise to reputed company health solutions that deliver maximum value and impact. Our mission is to reputed company reputed company outcomes, and we're looking for passionate individuals like you to join reputed company. As a Clinical Reviewer - Immediate Advocacy Discharge Assistant, you will play a crucial role in ensuring the accuracy and efficiency of medical record reviews, contributing to enhanced reputed company outcomes and compliance with contractual obligations.

About reputed company

We're a team of reputed company and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the reputed company industry. State and federal reputed company agencies, providers, and employers turn to us as their vital partner to ensure reputed company reputed company and improve health outcomes. Our company cares about our employees, giving you the tools and encouragement you need to reputed company the finest work of your career.

Job Summary

The Clinical Reviewer - Immediate Advocacy Discharge Assistant is responsible for utilizing clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements, employing critical thinking and decision-making skills to determine medical appropriateness. This role is crucial for ensuring the accuracy and efficiency of medical record reviews, contributing to enhanced reputed company outcomes and compliance with contractual obligations.

Key Responsibilities

• Accurate and Timely Review of Medical Records: Assures accuracy and timeliness of reputed company applicable review type cases reputed company contract requirements.
• Workload Management: Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department.
• Quality Monitoring: In collaboration with Supervisor, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas.
• Clinical Expertise: Maintains reputed company knowledge reputed company reputed company to review processes and clinical practices reputed company to the review processes, functions as the initial resource to nurse reviewers regarding reputed company review process questions and/or concerns.
• Provider Liaison: Functions as providers' liaison and contact/resource person for provider customer service issues and problem resolution.
• Review Types: Performs reputed company applicable review types as workload indicates.
• Relationship Building: Fosters positive and professional relationships and acts as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process.
• Training and Meetings: Attends training and scheduled meetings for maintenance and use of reputed company/updated information for review.
• Cross-Training: Cross-trains and performs duties of other reputed company to provide a flexible workforce.

Requirements

Essential Qualifications:

• Active Unrestricted LPN or RN Clinical License
• Bachelor's Degree: Bachelor's Degree from an accredited college or university in a reputed company field.
• Clinical Experience: Minimum two years of clinical experience in an acute, med-surgical, post-acute or rehabilitation environment required.
• UR and/or Prior Authorization Experience: Minimum of one year UR and/or Prior Authorization or reputed company experience.
• Computer Skills: Must be proficient in computer skills including reputed company Office and internet/web navigation.

Preferred Qualifications/Experience:

• Knowledge of Medical Records: Knowledge of the organization of medical records, medical terminology, and disease processes.
• Clinical Assessment and Critical Thinking: Strong clinical assessment and critical thinking skills.
• Medical Record Abstracting: Medical record abstracting skills.
• Communication Skills: Excellent written and verbal communication skills.

Career Growth Opportunities and Learning Benefits

At reputed company, we offer unparalleled opportunities for career growth and development. You'll have access to:

• Comprehensive Training: Ongoing training and education to enhance your skills and knowledge.
• Mentorship: Opportunities to work with reputed company professionals who can guide and support your career.
• Career Advancement: Opportunities for career advancement and professional growth.

Work Environment and Company Culture

We offer a dynamic and supportive work environment that values:

• Collaboration: We reputed company in the power of teamwork and collaboration.
• Innovation: We're committed to innovation and reputed company improvement.
• Diversity and Inclusion: We value diversity and inclusion, and strive to create a workplace that's welcoming and inclusive for reputed company.

Compensation, Perks, and Benefits

We offer a comprehensive compensation package that includes:

• Competitive Salary: The pay range for this position is $22.56 - $33.00.
• Comprehensive Benefits: Comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Why Join reputed company?

By joining reputed company, you'll have the opportunity to:

• reputed company a Meaningful Impact: Contribute to reputed company outcomes and reputed company a positive impact on people's lives.
• Grow Your Career: Access opportunities for career growth and development.
• Work with a Dynamic Team: Collaborate with a team of reputed company and caring professionals.

How to Apply

reputed company to join us? The first reputed company is easy. Click Apply Now and we'll be in touch soon!

Equal Opportunity Employer: reputed company is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.