RN — Clinical Utilization Review Specialist

VieMed, LLC; Lafayette (LA); Presencial; USD 60.000 - 85.000; Jornada completa

Descripción de la vacante

VieMed, LLC in Lafayette, LA seeks a detailed RN reviewer to assess patient records for prescribed therapies and equipment, ensuring regulatory and payer requirements are met. You will evaluate physician documentation and support referrals through accurate chart review.

The role emphasizes nursing judgment, documentation accuracy, and communication with physicians and insurers within a full-time, on-site setting.

Formación

• Current, active Registered Nurse (RN) license in good standing.
• Clinical nursing experience with demonstrated ability to review medical records and apply professional nursing judgement.
• Ability to read and interpret diagnoses, physician orders, progress notes and other clinical records.
• Strong attention to detail with the ability to identify incomplete or conflicting documentation.

Responsabilidades

• Conduct clinical reviews of patient records to evaluate coverage requirements for prescribed therapies and equipment.
• Review physician orders, progress notes, histories, physicals, and diagnostic information relevant to referrals.
• Identify missing or unclear documentation and communicate deficiencies to appropriate parties.
• Apply nursing knowledge to evaluate diagnoses, treatment history, and medical-necessity indicators.
• Provide recommendations on referral readiness and next steps based on chart-review findings.
• Maintain compliance with Medicare, Medicaid, and payer documentation requirements.

Conocimientos

RN license

Clinical review

Medical documentation

Communication

Attention to detail

Herramientas

EMR systems

Microsoft Office

Descripción del empleo

VieMed, LLC in Lafayette, LA seeks a detailed RN reviewer to assess patient records for prescribed therapies and equipment, ensuring regulatory and payer requirements are met. You will evaluate physician documentation and support referrals through accurate chart review.

The role emphasizes nursing judgment, documentation accuracy, and communication with physicians and insurers within a full-time, on-site setting.