Position Summary: Review of medical charts in order to justify appropriate billing to insurance companies for inpatient or observation services. Communicates the complexity of the patient’s illness and the treatment provided to the insurance company to obtain authorization for services. Works closely with physicians to help provide education on clinical documentation improvement. Completes psycho social screenings on all patients that are determined to be at risk for post-hospitalization needs. Assists patients and families with advance directives and end-of-life goal clarification. Communicates with WV DHHR (APS/CPS) when elements of abuse or neglect are present. Requires strong problem-solving abilities, self-motivation, resourceful thinking, and a strong clinical nursing background.Position Qualifications:Minimum Education: Associate’s Degree in NursingPreferred Education: Bachelor’s Degree in NursingRequired Courses(s)/Training: 2 years of acute hospital experience preferred. Experience in discharge planning or utilization review specialty area is preferred.Required Credentials: Current WV RN licenseRequired Certification(s): BLSACM certification within two years
