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Job description
Location: Torrance, California
Type: Travel
Job
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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*
Worksite address
torrance, CA, 90504, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.