Utilization Review Appeals Specialist

A company is looking for a Utilization Rev Appeals Specialist.

Key Responsibilities

Review patient medical records to determine reasons for denials and required appeals

Collaborate with various departments and make appeal referrals to internal and external physician advisors

Document all denied services and maintain records throughout the appeal process

Required Qualifications

An Associate degree in Health Information Technology with RHIT certification or Associate degree RN

2-5 years of experience in Utilization Management, Appeals Management, or Case Management

Current / active certification / licensing through a professional association

Required computer skills including Microsoft Office applications and EHR

Ability to maintain confidentiality according to HIPAA regulations