Clinical Utilization & Authorization Specialist

Priority Dispatch Corp.; Hettinger (ND); On-site; USD 52,000 - 70,000; Full time

Job summary

West River Health Services is seeking a Hospital Information Management professional to monitor utilization, risk, and quality of care under the HIM Manager. The role involves chart reviews, discharge planning coordination, and ensuring medical necessity for services.

Required are 3+ years in HIM, with at least 1 year in healthcare settings. LPN license or RHIT credential is required to qualify.

Qualifications

• 3 years relevant experience in HIM/health information management.
• Minimum 1 year healthcare/clinical experience required.
• LPN or RHIT credential required.

Responsibilities

• Perform preadmission and retrospective chart reviews.
• Coordinate with discharge planning on medical necessity and level of service.
• Obtain preauthorization, precertification, and length-of-stay extensions.
• Review hospital records daily for appropriate care environment placement.

Skills

Preadmission reviews

Discharge planning

Preauthorization

Clinical documentation

Education

LPN license

RHIT credential

Job description

West River Health Services is seeking a Hospital Information Management professional to monitor utilization, risk, and quality of care under the HIM Manager. The role involves chart reviews, discharge planning coordination, and ensuring medical necessity for services.

Required are 3+ years in HIM, with at least 1 year in healthcare settings. LPN license or RHIT credential is required to qualify.