The Rehabilitation Hospital of Indiana is located on the northwest side of Indianapolis. RHI provides quality service to those facing life-changing injuries or illness. Featured as the only Traumatic Brain Injury (TBI) Model System in the state of Indiana as well as a CARF-certified rehabilitation center.

Summary:

The Utilization Reviewer contributes to assessment and planning by performing a thorough review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful transition to the discharge setting and or goal achievement, and durability of outcome.

Essential Functions

• Assesses all of patient's payer sources for rehabilitation course, determines resources available for patient, and ensures maximal use of available health coverage resources for each patient.
• Completes pre-certification and prior authorization timely for admission and or services.
• Documents all insurance information appropriately on forms and in computer system as applicable.
• Functions as liaison with payer representatives to manage the rehabilitation process in keeping with the patient's financial resources, including verification of benefits for this and future settings.
• Completes retro authorizations as applicable and ensures follow through relative to authorizations for all services through the complete revenue cycle.
• Other duties as assigned.

Education and Experience

• Greater than 2 years of UR experience with a strong clinical background and competence with a rehabilitation population.
• Bachelor's degree in related field with 3-5 years' experience

The Rehabilitation Hospital of Indiana is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, or any other characteristic protected by law.