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If you are interested in learning more about the opportunities available here, please contact our human resources department at:

Human resources department
915 Anderson Drive
Aberdeen, WA 98520
360.537.5118
360.537.5051(fax)
jobs@ghcares.org
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Utilization Review/Clinical Documentation Specialist / FT 1.0 /CT-9

Category:

Care Transition

Department:

Care Transition

Status:

Full Time / 1.0 FTE

Schedule:

Varied Days

Description:

Position Summary:

  • Responsible for evaluating appropriateness of hospitalization of acute care and observation services
  • Conducts admission, concurrent, and retrospective reviews for Interqual criteria
  • Interacts with patients, Medical Staff and Hospital staff to evaluate the utilization status of patients when necessary
  • Provides level of care information using National standards.
  • Responsible for improving the overall quality and completeness of clinical documentation
  • Facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and medical records coding staff to ensure that appropriate reimbursement is received for the level of service rendered to all patients with a DRG based payor (Medicare, Medicaid, etc)
  • Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and hospital outcomes
  • Educates all members of the patient care team on an on-going basis.

Job Requirements:

  • Licensed Nurse (RN preferred or LPN with UR background) in the state of Washington
  • At least four (4) years experience in acute hospital settings
  • At least one (1) year experience in Utilization Review and/or two (2) years ICD-10 experience
  • Exceptional interpersonal communications
  • Ability to communicate effectively in both verbal and written formats
  • Exceptional organizational skills
  • Demonstrated knowledge of DRG payor issues (Medicare, Medicaid, etc) including clinical documentation, referral policies, and procedures
  • Ability to use CDMPTrak, member of the CDMP Task Force
  • Knowledge of Medicare, State and private insurance requirements for acute care
  • Effectively interact with other hospital department
  • Firm grasp and compliance with HIPAA regulations
  • Excellent computer skills with ability to utilize Word, Excel, Outlook and Meditech.

Full Time 1.0 FTE / Varied Days

Closing:

Open until filled

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Contact

915 Anderson Dr.
Aberdeen, WA 98520
360.532.8330