Job Description

• Location: Torrance, California
• Type: Travel
• Job 17789408
• Apply Now

Acute Hospital Experience by Specialty

Pediatrics*
ICU
MS
Case Management/Utilization Review

Pre-Cert Review*
Prior Authorizations*
Retrospective Review*
Admission Criteria
Care coordination
Concurrent Review
Continued Stay Reviews
Determine Medical Necessity per Evidence-Based Guidelines
Disease management
Plan of Care
Utilize InterQual Criteria
Utilization Review

Pre-Cert Review*
Prior Authorization*
Retrospective Review*
Admission Criteria
Concurrent Review
Continued Stay Reviews
CPT (Current Procedural Terminology) coding and billing
Medical Necessity
Utilize InterQual Criteria
Work Settings

Acute Hospital
Ambulatory
Regulatory

CMS: Centers for Medicare and Medicaid Services
CPT (Current Procedural Terminology) coding and billing
Department of Health
DRG (Diagnosis Related Groups)
HIPAA guidelines (Health Insurance Portability and Accountability Act)
The Joint Commission/ Core Measure/National Safety Goals
Additional Skills

remote UR work
CA and Medi-Cal experience/knowledge*

Job Tags

Remote work

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