Utilization Review Specialist job at Einstein Healthcare Network in Elkins Park

Einstein Healthcare Network is at present recruited Utilization Review Specialist on Tue, 15 May 2018 02:01:58 GMT. A minimum of 3-4 years experience as a registered nurse. These are the qualities that have earned MossRehab its outstanding reputation at the local, regional...

Utilization Review Specialist

Location: Elkins Park, Pennsylvania

Description: Einstein Healthcare Network is at present recruited Utilization Review Specialist right now, this job will be situated in Pennsylvania. Further informations about this job opportunity kindly see the descriptions.

Since 1959, MossRehab has provided our patients with a breadth of expertise unrivaled in the region. Superior clinical expertise, nationally recognized rehabilitation specialists, unsurpassed diagnostic capabilities, a passion for advocacy, a patient centered team philosophy and a quest for continuous improvement. These are the qualities that have earned MossRehab its outstanding reputation at the local, regional and national levels and enable us to attract and retain highly motivated, gifted rehabilitation professionals. In fact, U.S. News & World Reports has consistently ranked us among the nation’s best rehabilitation facilities. We were also named one of the best employers in the Philadelphia area this year, come find out why! Einstein Healthcare Network promotes wellness. Research has shown that smoking is dangerous to the health of smokers and to others. Einstein campuses are Tobacco and Smoke Free.

In this role you will be responsible for:

• Determines appropriate utilization of acute inpatient rehab (IRF) care, subacute care and skilled care resources in accordance with government guidelines, third party payor rules and regulations, and the MossR ehab Utilization Review Plan
• Performs concurrent chart reviews with third party payors
• Prepares letter of appeal
• Reviews patient records for payor audit requests and manages responses to denials
• Provides backup to IRF Prospective Payment System staff

If you possess the following qualifications, please apply immediately:

• Successful completion of an accredited registered Bachelors of Nursing program and a current Pennsylvania State License
• A minimum of 3-4 years experience as a registered nurse
• A minimum of two years prior Utilization Review experience preferred
• Current Pennsylvania State RN License

Physical Demands:

• Requires standing, sitting, and/or walking greater than 6 hours out of an 8-hour workday lifting a maximum of 50 pounds occasionally and frequent lifting of up to 25 pounds

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

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This job will be opened on: Tue, 15 May 2018 02:01:58 GMT