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Utilization Review Specialist
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- Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
- Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
- Evaluate the utilization program for compliance with regulations, policies and procedures.
- Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
- Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.
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