| Job Title |
Utilization-review Coordinator |
| Job Description |
Analyzes Patient Records To Determine Legitimacy Of
Admission, Treatment, And Length Of Stay In Health-care
Facility To Comply With Government And Insurance Company
Reimbursement Policies: Analyzes Insurance, Governmental, And
Accrediting Agency Standards To Determine Criteria Concerning
Admissions, Treatment, And Length Of Stay Of Patients. Reviews
Application For Patient Admission And Approves Admission Or
Refers Case To Facility Utilization Review Committee For Review
And Course Of Action When Case Fails To Meet Admission
Standards. Compares Inpatient Medical Records To Established
Criteria And Confers With Medical And Nursing Personnel And
Other Professional Staff To Determine Legitimacy Of Treatment
And Length Of Stay. Abstracts Data From Records And Maintains
Statistics. Determines Patient Review Dates According To
Established Diagnostic Criteria. May Assist Review Committee In
Planning And Holding Federally Mandated Quality Assurance
Reviews. May Supervise And Coordinate Activities Of Utilization
Review Staff.
|
