Utilization Reviewer (FT) - Onsite

Rehabilitation Hospital of Indiana (RHI); Indianapolis (IN); On-site; USD 65,000 - 82,000; Full time

Benefits offered by this job

401k match

Tuition reimbursement

Job summary

The Rehabilitation Hospital of Indiana (RHI) is seeking an Utilization Reviewer to assess patient payer sources, determine resources available for rehabilitation, and ensure maximal use of health coverage throughout the care continuum.

This on-site role at RHI requires >2 years UR experience with a strong clinical background and rehabilitation population competence, a related Bachelor's degree (3–5 years' experience preferred, LPN or RN preferred), and collaboration with payers and clinical

Qualifications

• Greater than two (2) years of UR experience with a strong clinical background and competence with a rehabilitation population.
• Bachelor's degree in related field with 3-5 years' experience; LPN or RN experience preferred.

Responsibilities

• Assesses all of patient's payer sources for rehabilitation course, determines resources available for patient, and ensures maximal use of available health coverage resources for each patient.
• Completes pre-certification and prior authorization timely for admission and or services.
• Documents all insurance information appropriately on forms and in computer system as applicable.
• Functions as liaison with payer representatives to manage the rehabilitation process in keeping with the patient's financial resources, including verification of benefits for this and future settings.
• Completes retro authorizations as applicable and ensures follow through relative to authorizations for all services through the complete revenue cycle.
• Other duties as assigned.

Skills

UR experience

Clinical background

Rehabilitation population

Education

Bachelor's degree in related field

LPN or RN experience preferred

Job description

The Rehabilitation Hospital of Indiana (RHI) is nationally ranked among the Best Hospitals for Rehabilitation by U.S. News and World Report for 2025-2026 and the Best Rehabilitation Hospital in Indiana for the third year in a row. RHI provides high quality, evidence-based rehabilitation services to those facing life-changing injuries or illness. RHI is the only Traumatic Brain Injury (TBI) Model System in the state of Indiana and one of only 16 in the U.S We offer a competitive compensation and benefits package, along with a 401k match and tuition reimbursement program.

Summary:

The Utilization Reviewer contributes to assessment and planning by performing a thorough review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful transition to the discharge setting and or goal achievement, and durability of outcome.

Essential Functions

• Assesses all of patient's payer sources for rehabilitation course, determines resources available for patient, and ensures maximal use of available health coverage resources for each patient.
• Completes pre-certification and prior authorization timely for admission and or services.
• Documents all insurance information appropriately on forms and in computer system as applicable.
• Functions as liaison with payer representatives to manage the rehabilitation process in keeping with the patient's financial resources, including verification of benefits for this and future settings.
• Completes retro authorizations as applicable and ensures follow through relative to authorizations for all services through the complete revenue cycle.
• Other duties as assigned.

Education and Experience

• Greater than two (2) years of UR experience with a strong clinical background and competence with a rehabilitation population
• Bachelor's degree in related field with 3-5 years' experience
• LPN or RN experience preferred

Hours

• Monday - Friday (8:30am-5:00pm)
• This position is on-site at RHI

The Rehabilitation Hospital of Indiana is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, or any other characteristic protected by law.