Utilization Review Specialist | LPN/RHIT Expert

Priority Dispatch Corp.; North Dakota; Hybrid; USD 29,000 - 36,000; Full time

Job summary

West River Health Services in Hettinger, ND seeks an experienced Utilization Review Specialist to monitor resource use, ensure medical necessity, and support payer authorizations. The role reports to the HIM Manager and focuses on chart reviews and coordination with discharge planning.

The position emphasizes accurate documentation, adherence to guidelines, and timely preauthorization processes in a rural hospital setting. Experience in clinical environments is required.

Qualifications

• LPN license or RHIT credential (coding certifications also acceptable: CCS, CCS-P, CPC, CPC-H)
• 3 years relevant experience; minimum 1 year healthcare/clinical experience

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 coordination

Medical necessity reviews

Payer authorization

Education

RHIT credential

LPN license

CCS/CCS-P/CPC/CPC-H

Job description

West River Health Services in Hettinger, ND seeks an experienced Utilization Review Specialist to monitor resource use, ensure medical necessity, and support payer authorizations. The role reports to the HIM Manager and focuses on chart reviews and coordination with discharge planning.

The position emphasizes accurate documentation, adherence to guidelines, and timely preauthorization processes in a rural hospital setting. Experience in clinical environments is required.