Utilization Review Coordinator

::Coordinates the medical review of established medical criteria for admission and continued stay.? Works closely with the physicians to ensure that the Utilization Review Plan is being followed.? Helps with physician and staff education regarding documentation and other applicable material.? Prepares monthly statistical reports.? Works closely with representatives from Blue Cross, CIMRO, PROs, and other third-party payors and review agencies to ensure that the utilization review requirements of all contractual agreements are being followed.? Focus is on securing reimbursement for hospital? Is an integral link between financial services and the clinical team


  • Licensed as a Registered Nurse in Illinois

  • At least one(1) year experience in psychiatric nursing and utilization review.

  • Must be accurate and dependable in the performance of his/her duties and responsibilities.He/she must conduct business in a professional manner.He/she must communicate effectively, both verbally and in writing.He/she must possess a thorough understanding of reimbursement issues.

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