Pennsylvania Licensed Utilization Management RN

Job Summary

A company is looking for a Utilization Management RN & Coding Specialist.

Key Responsibilities

• Review and extract case details from patient medical records and compose appeal letters
• Utilize coding systems (ICD-9, ICD-10, CPT, HCPCS) and provide education on coding compliance
• Participate in ALJ hearings and maintain adherence to company policies and quality expectations

Required Qualifications

• Associate's degree
• One of the following Coding Certifications: CCS, CCS-P, CPC-H, CPC, RHIT, RHIA, CDIP, CCDS
• Unrestricted RN license in state of residence
• 3+ years of experience in ED, Telemetry, or CCU
• 1+ years of inpatient coding experience or active coding certification with concurrent inpatient DRG coding experience