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California Licensed Utilization Management RN
A company is looking for a Pre-Service Utilization Management RN. Key Responsibilities Review requests for referral authorizations and gather necessary information for determinations Ensure compliance with turnaround times and accuracy standards while coordinating patient care Compose denial letters and notices in compliance with regulations and guidelines Required Qualifications Minimum of 3 years' recent clinical experience required Graduate of an accredited RN Program Clear and current CA Registered Nurse (RN) license Knowledge of ICD-10, CPT, HCPCS coding, and medical terminology Understanding of legal and ethical considerations related to patient information and HIPAA regulations
A company is looking for a Pre-Service Utilization Management RN.
Key Responsibilities
Review requests for referral authorizations and gather necessary information for determinations
Ensure compliance with turnaround times and accuracy standards while coordinating patient care
Compose denial letters and notices in compliance with regulations and guidelines
Required Qualifications
Minimum of 3 years' recent clinical experience required
Graduate of an accredited RN Program
Clear and current CA Registered Nurse (RN) license
Knowledge of ICD-10, CPT, HCPCS coding, and medical terminology
Understanding of legal and ethical considerations related to patient information and HIPAA regulations