RN Utilization Review Specialist

VieMed, LLC; Lafayette (LA); In loco; USD 55.000 - 69.000; Tempo pieno

Descrizione del lavoro

VieMed, LLC in Lafayette, LA is seeking a nurse reviewer to assess patient records and documentation for therapy approvals. You will apply nursing judgment, ensure payer criteria alignment, and document findings in the EMR.

Strong communication with physicians and insurers, HIPAA compliance, and the ability to prioritize multiple chart reviews within standard business hours are essential for success. On-site role, weekdays.

Competenze

• Active RN license in good standing.
• Experience reviewing medical records and applying nursing judgement.
• Ability to read diagnoses, orders and clinical notes.
• Familiarity with Medicare/Medicaid and payer documentation.
• Strong attention to detail and communication skills.
• Proficiency with EMR and MS Office.

Mansioni

• Review patient medical records and referral documentation to evaluate therapy/ equipment coverage.
• Review physician orders, progress notes, histories, and diagnostic data.
• Identify missing or unclear documentation and communicate needs.
• Apply nursing knowledge to evaluate diagnoses and treatment history.
• Provide recommendations on readiness and next steps.
• Assess documentation against payer criteria before submission for reimbursement.
• Maintain compliance with regulations and VieMed procedures.
• Document findings and escalate complex questions as needed.
• Perform other duties as assigned.

Conoscenze

Clinical nursing experience

Nursing judgment

Medical terminology

Insurance concepts

Documentation accuracy

Communication skills

Analytical skills

Formazione

RN license

Strumenti

EMR systems

Microsoft Office (Outlook/Word/Excel)

Descrizione del lavoro

VieMed, LLC in Lafayette, LA is seeking a nurse reviewer to assess patient records and documentation for therapy approvals. You will apply nursing judgment, ensure payer criteria alignment, and document findings in the EMR.

Strong communication with physicians and insurers, HIPAA compliance, and the ability to prioritize multiple chart reviews within standard business hours are essential for success. On-site role, weekdays.