Active clinical license or credential required. Qualifying credentials include: Licensed Practical Nurse (LPN), Physical Therapist (PT), Occupational Therapist (OT), Physical Therapist Assistant (PTA), Certified Occupational Therapy Assistant (COTA), Speech-Language Pathologist (SLP), Respiratory Therapist (RT), Medical Assistant (CMA/RMA), or equivalent clinically credentialed healthcare professional. Credential must be in good standing with the applicable state licensing board.
Preferred (2) years of clinical experience in an acute care hospital, rehabilitation, skilled nursing, or related inpatient/post-acute setting preferred.
Working knowledge of medical terminology, clinical documentation, and patient care workflows in an inpatient environment.
Familiarity with insurance terminology, prior authorization processes, and payer-specific concurrent review requirements preferred.
Familiarity with CMS rules relevant to inpatient care (e.g., Two-Midnight Rule, inpatient vs. observation status, Important Message from Medicare, MOON notice) preferred; training will be provided.
Proficiency with Microsoft Office (Outlook, Word, Excel) and ability to learn hospital information systems (Meditech, Midas, Providerlink, payer portals).
A certification such as Certified Case Manager (CCM), Certified Utilization Review Professional (CURP), or Certified Revenue Cycle Specialist (CRCS) is a plus but not required.
