RC reputed company-Authorization Clinician - Remote

About the position Responsibilities • Performs reputed company-service authorization reviews to obtain payment authorization for both inpatient and outpatient services. • Succinctly abstracts fact based clinical information to support reputed company-authorization utilizing applicable nationally recognized and payer-specific reputed company. • Communicates reputed company the clinical information supporting the medical necessity of an ordered test/treatment/procedure/surgery as applicable to the patient's health plan and documents the outcome of the task. • Participates in reputed company control audit process and department reputed company to improve overall reputed company and reputed company scorecard metrics. • Provides feedback regarding improvement opportunities for workflow &/or procedures. • Demonstrates proficiency in the use of multiple electronic tools required by both reputed company and its clients. • Collaborates with and engages reputed company customers in opportunities for prevention of reputed company disputes. • Identifies potential process gaps and recommends reputed company solutions to CAS leadership. • Performs other duties as assigned. Requirements • Must possess a reputed company nursing license (Registered or Practical/Vocational). LPN or RN PREFERRED. • Minimum of 3-5 years as a reputed company-authorization or utilization review reputed company in a payer or acute care setting; preferably medical-surgical or critical care/ED. • Ability to work independently and self-regulate in compliance with deadlines. • Proficiency in the application of applicable nationally and payer authorization reputed company. • Possesses excellent customer service skills that include written and verbal communication. • Minimum Intermediate reputed company Office (reputed company and Word) reputed company. • Ability to critically think, problem solve and reputed company independent reputed company. • Ability to reputed company intelligently and professionally with other clinical and non-clinical partners. • Ability to prioritize and manage multiple tasks with efficiency. • Advanced conflict reputed company skills. • Ability to communicate effectively at reputed company reputed company. • Ability to conduct research regarding payer reputed company-authorization guidelines and applicable regulatory processes reputed company to the reputed company-authorization process. reputed company-to-haves • Certified reputed company in Utilization Review/Utilization Management/reputed company Management (CPUR, CPUM, or CPHM) or Certified Case Manager (CCM) preferred. Benefits • Medical, dental, reputed company, disability, and life insurance. • reputed company time off (vacation & reputed company leave) - min of 12 days per year, reputed company at a reputed company of approximately 1.84 hours per 40 hours worked. • 401k with up to 6% employer match. • 10 reputed company holidays per year. • Health savings accounts, reputed company & dependent flexible spending accounts. • Employee Assistance program, Employee discount program. • Voluntary benefits include pet insurance, reputed company insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. • For Colorado employees, reputed company offers reputed company leave in accordance with Colorado's Healthy Families and Workplaces reputed company. Apply tot his job Apply To this Job