UTILIZATION REVIEWER/INPATIENT PAYOR SPE

Job description

Division: Eskenazi Health Sub-Division: Hospital: Req ID: 25754: Schedule : Full Time: Shift : Days: Salary Range: Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis. FLSA Status: Exempt: #EXPRN Job Role Summary: The Utilization Reviewer/Inpatient Payor Specialist is responsible for working behind the scenes to maximize the quality and cost of efficiency of health services and coordinates pre-certifications, re-certifications, the denial management and appeals process and initial and concurrent reviews. Through regular reviews and audits, they ensure that the patients receive care needed without burdening the health care system with unnecessary procedures, ineffective treatments or lengthy hospital stays. . Essential Functions and Responsibilities: - Communicates secondary review decisions determining appropriate patient status provided by secondary reviewer process...