RN Utilization Review Specialist

VieMed Healthcare

Lafayette (LA)

In loco

USD 60.000 - 80.000

Tempo pieno

3 giorni fa

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Descrizione del lavoro

VieMed Healthcare in Lafayette, LA seeks a qualified Registered Nurse to perform chart reviews, assess medical documentation for prescribed therapies and equipment, and ensure payer requirements are met. You will apply nursing judgment to determine medical necessity, document findings, and escalate complex cases as needed.

This role supports compliance with HIPAA and VieMed procedures while coordinating with intake leadership.

Competenze

Current, active RN license in good standing.
Clinical nursing experience reviewing medical records and documentation.
Ability to apply nursing judgement to evaluated documentation.

Mansioni

Review patient records to assess documentation supports prescribed therapies and equipment.
Evaluate clinical documentation against payer criteria before submission for reimbursement.
Identify missing or unclear documentation and communicate deficiencies.
Document findings and recommendations in the designated system.
Escalate complex questions to Intake leadership as needed.
Maintain compliance with regulations and VieMed procedures.
Work Monday through Friday; overtime or on-call may be required.