Utilization Review Case Manager
Halifax Health(3 months ago)
About this role
A Utilization Review Case Manager is a nursing professional who evaluates hospitalized patients' clinical records to determine medical necessity and support appropriate reimbursement. The role serves as a clinical-billing liaison between the hospital, clinical teams, and payers to help reduce denials and preserve revenue.
Required Skills
- Medical Review
- Clinical Documentation
- Appeals Management
- Care Coordination
- Billing Knowledge
- Electronic Health Records
- Communication
- Time Management
- Patient Advocacy
- Benefit Research
+2 more
Qualifications
- LPN
- RN
- Florida Nursing License
About Halifax Health
halifaxhealth.orgAt Halifax Health, we have board certified physicians who provide compassionate care in a loving environment.
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