* Supportive role for Utilization Review RN and Utilization Management Coordinator. * Participates in communication and collaboration with insurance payors, Internal Physician Advisors, community Providers, and Renown staff for coordination of authorization of patient stay. * Requires critical thinking, collaboration, and communication. * Works alongside Utilization Review RN and Utilization Management Coordinators to ensure the following: o Ensure authorization notices are placed in electronic medical records. o Verify provider orders and patient status are updated appropriately and accurately prior to admission for elective surgeries. o Coordinate peer-to-peer discussions between providers for denials management. o Support the Utilization Review RN with timely submission of clinical documentation via fax to insurance payors. * Manages multiple fax lines while monitoring various reports and insurance portals for authorization notifications. * Collaborate with community providers to ensure appropriate orders are reflected on surgical accounts prior to the day or surgery. KNOWLEDGE, SKILLS, & ABILITIES * Must respect beliefs and values while advocating for the patient's right to self-determination and to make informed choices. * Documents all chart and phone reviews, identifies, and communicates potentially avoidable/non-reimbursed days, and quality indicators (such as re-admissions). * This position acquires and maintains knowledge and competencies related to the expectations of their role. Practice is aligned with the mission, vision, and goals of the Integrated Health System. * Must be able to prioritize and assess situations while maintaining quality services under stressful conditions. This position provides clerical and support services. This position does not provide patient care.
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Renown Health
Jan 09, 2026