Apr 18, 2025
The Utilization Review/Case Manager will assure maximum coverage by third party payers for patients utilizing services; monitor patient records concurrently for necessary documentation and adherence to criteria. Facilitates improvement in the overall quality, completeness, and accuracy of medical record documentation. Obtains appropriate clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and coding staff to ensure that clinical documentation reflects the level of service rendered to patients is complete and accurate. BASIC FUNCTION: Concurrently and retrospectively reviews patient medical record utilizing specific medical care review criteria to assure proper utilization of hospital facilities and/or resources, and documentation in compliance with all rules and regulations as promulgated by third party payors, thus minimizing financial loss to the hospital and the patient. Contacts various insurance carriers to provide...
Amberwell Health Atchison
Atchison, KS, USA