Compensation

Utilization Review Coordinator

UW CODE AND REPRESENTATIVE GROUP

18028 (NE S SEIU 925 Non Supv)
22472 (NE H NI SEIU 925 Non Supv)

CLASS SERIES CONCEPT

Assess chart documentation to determine appropriateness of hospitalization of patients in an acute care setting;

BASIC FUNCTION

Justify admission and length of stay of designated patients as required for agency reimbursements; abstract and code patient data;

DISTINGUISHING CHARACTERISTICS

Under general direction, review chart documentation to justify patient care in order to meet agency reimbursement requirements;

TYPICAL WORK

Review all designated admissions for appropriateness; follow-up at predetermined intervals for continued stay;

Monitor patient length of stay, evaluate for variation from regulatory agency standards and consult with physician advisor as necessary;

Complete patient abstracts per agencies’ guidelines;

Participate with Quality Assurance Department in compiling data for audits;

Justify, in writing, the patients’ need for continued hospitalization;

Assist in coordinating monthly meetings;

Attend meetings or conferences to maintain professional accreditation;

May take minutes of scheduled meetings;

May compile and maintain departmental record systems;

Perform related duties as required.

MINIMUM QUALIFICATIONS

Graduation from an accredited School of Nursing of Health Care Records Program approved by the American Medical Records Association;

Equivalent education/experience will substitute for all minimum qualifications except when there are legal requirements, such as a license/certification/registration.

CLASSIFICATION HISTORY

12/14/1973: New Class
12/07/1978: Revise Title & Class
10/24/1983: Revise Class
07/02/1990: Revise MQ
06/01/2005: CSR Class Conversion