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Chart Utilization Review Jobs in Indiana (NOW HIRING)

Suburban Home Health

OASIS Review Nurse

Noblesville, IN · On-site

Assists with other chart activities as assigned * Partners with the Utilization Review Lead on a variety of quality and performance improvement initiatives Requirements Basic Qualifications * Must be ...

UHS

THERAPIST (MA/MSW)

Bloomington, IN · On-site

Ensures timely completion and documentation of outpatient utilization review. Assists with clinical chart audits and staff education associated with quality improvements. Exempt level position.

UHS

UNIT CLERK- Behavioral Health

Franklin, IN · On-site

Such materials involve staff development, shift assignment reports, nightly chart audit, daily ... Utilization Review: initiates pre-certification calls for private insurance and managed Medicare ...

Beacon Health System

Specialty Reg Nurse

Granger, IN

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

Beacon Health System

Specialty Reg Nurse

Granger, IN · On-site

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

Beacon Health System

Specialty Reg Nurse

Granger, IN · On-site

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

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Chart Utilization Review information

What are the key skills and qualifications needed to thrive as a Chart Utilization Review specialist, and why are they important?

To thrive as a Chart Utilization Review specialist, you need a background in healthcare, strong knowledge of medical terminology, and experience with patient care documentation, often supported by an RN or LPN license. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately reviewing charts and collaborating with healthcare providers. These abilities ensure compliance, optimize patient care, and support cost-effective healthcare delivery.

What is Chart Utilization Review?

Chart Utilization Review is a process commonly used in healthcare settings to assess the necessity, appropriateness, and efficiency of medical services provided to patients. It involves reviewing patient charts and medical records to ensure that treatments and procedures are justified according to established guidelines and policies. This process helps in improving patient care, managing costs, and ensuring compliance with regulatory requirements. Utilization review professionals work closely with medical staff, insurance companies, and regulatory agencies to support quality and cost-effective care.

What are some common challenges faced by professionals in Chart Utilization Review, and how can they be addressed?

Professionals in Chart Utilization Review often encounter challenges such as navigating incomplete or inconsistent medical documentation, staying current with ever-evolving healthcare regulations, and balancing productivity with accuracy. To address these challenges, it is important to maintain open communication with clinical staff, participate in ongoing training, and utilize robust electronic health record systems. Additionally, collaborating closely with interdisciplinary teams can help clarify documentation and ensure compliance with regulatory standards.

What is the difference between Chart Utilization Review vs Chart Review Specialist?

AspectChart Utilization ReviewChart Review Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires medical or coding certifications
Work EnvironmentHealthcare facilities, insurance companies, utilization management teamsMedical offices, insurance companies, coding firms
Employer & IndustryHospitals, insurance providers, healthcare organizationsMedical billing companies, insurance firms, healthcare providers
Primary FocusAssessing medical necessity and appropriateness of servicesReviewing medical records for coding accuracy and completeness

While both roles involve reviewing medical information, Chart Utilization Review focuses on evaluating the necessity of healthcare services, whereas Chart Review Specialists primarily verify medical documentation for coding and billing accuracy. Understanding these distinctions helps professionals choose the right career path or job search focus.

What are popular job titles related to Chart Utilization Review jobs in Indiana? For Chart Utilization Review jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Chart Utilization Review jobs in Indiana look for? The top searched job categories for Chart Utilization Review jobs in Indiana are:
What cities in Indiana are hiring for Chart Utilization Review jobs? Cities in Indiana with the most Chart Utilization Review job openings:
Chart Utilization Review jobs near you

OASIS Review Nurse

Hancock Health Job Openings - APPLY TODAY!

Noblesville, IN • Hybrid

Other

Posted 13 days ago

Job description

Suburban Home Health is a jointly owned venture between several Suburban Health Organization hospital systems here in central Indiana! We work as an extension of the hospital consortiums you trust in your community, with the goal of improving care across the continuum for our homebound patients. This is a hybrid role with occasional in-office expectations in our corporate office located in Noblesville, IN.

The Utilization Review Nurse is responsible for reviewing patient assessments to assist the Quality Improvement department in identifying areas for improvement to maximize reimbursement.

  • Reviews patient assessments to assist the Quality Improvement department in identifying areas for improvement to maximize reimbursement.
  • Reviews clinical documentation to ensure OASIS accuracy and compliance with Medicare Home Health regulatory standards
  • Monitors performance improvement initiatives regarding patient outcomes
  • Identifies trends and patterns of inaccuracy to assist in the development of the performance improvement plan
  • Reviews, monitors, and evaluates the clinicians documentation of treatment or plan of care given to their patients to ensure the patient is getting the best practice skilled care
  • Performs regular review of patient care records, which includes verifying that information in MD orders, comprehensive assessments OASIS, care plans and clinical documentation correspond appropriately
  • Performs clinical record review which includes verification of documentation, quality of care provided, visit utilization, adherence to the plan of care and evidence of communication between all disciplines.
  • Collects data and prepares various quality, audit and performance improvement reports
  • Participates in new hire OASIS training, ongoing training, and process improvement initiatives
  • Maintains working knowledge of home health regulations, conditions of participation and OASIS
  • Collaborates with and educates clinicians as necessary should documents need to be edited
  • Assists with other chart activities as assigned
  • Partners with the Utilization Review Lead on a variety of quality and performance improvement initiatives

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