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The Joint Commission

Oakbrook Terrace, Illinois

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The Joint Commission

Oakbrook Terrace, Illinois

Tower Surgical Partners

Rockville, Maryland

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Unity Healthcare

Lafayette, Indiana

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Duke University Health System

Durham, North Carolina

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RN Clinical Access Specialist - Utilization Management
Job SummaryGeisinger is hiring a RN Clinical Access Specialist for Geisinger Medical Center in Danville, PA. The primary function of this role is completing Point of Entry reviews for the emergency room. Additionally this role performs reviews of SORU/Inpatient procedures to ensure correct operative status at the time of surgery.Job DutiesPerforms and ensures adherence to state, federal and third party payer certification requirements for initial, concurrent and retrospective medical record review for medical necessity and level of care determination.Identifies and notifies appropriate staff regarding discrepancy issues with third party payer health insurance coverage and lack of coverage.Maintains a working knowledge of third party payer hea


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