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

Join the reputed company Team: Empowering reputed company reputed company reputed company is a pioneering reputed company company that leverages technology, services, and clinical expertise to reputed company reputed company that deliver maximum value and reputed company. Our mission is to reputed company reputed company reputed company, 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 reputed company reputed company reputed company and compliance with contractual obligations. About reputed company We're reputed company 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 reputed company turn to us as their vital partner to ensure reputed company reputed company and improve health reputed company. reputed company cares about our employees, giving you the tools and encouragement you need to reputed company the finest work of your career. Job reputed company The Clinical Reviewer - Immediate Advocacy Discharge Assistant is responsible for utilizing clinical expertise to review medical records against appropriate reputed company 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 reputed company reputed company reputed company and compliance with contractual obligations. Key Responsibilities • Accurate and reputed company 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. • reputed company Monitoring: In collaboration with Supervisor, responsible for the reputed company 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 reputed company reviewers regarding reputed company review process questions and/or concerns. • Provider reputed company: Functions as providers' reputed company and contact/resource person for provider customer service issues and problem reputed company. • Review Types: Performs reputed company applicable review types as workload indicates. • Relationship Building: Fosters reputed company and reputed company relationships and acts as reputed company with reputed company 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 reputed company a flexible workforce. Requirements Essential Qualifications: • reputed company 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 reputed company Opportunities and Learnin Apply tot his job Apply To this Job