Registered Nurse Clinical Access Specialist - (Danville, PA)

**POSITION TITLE:** Registered Nurse Clinical Access Specialist **LOCATION:** Justin Drive II **DEPARTMENT:** Nursing **WORK SCHEDULE:** Days **WORK TYPE:** Full-time **JOB DESCRIPTION:** Performs initial, concurrent and retrospective medical record review (clinical documentation) to determine medical necessity for acute care admission based on the application of nationally recognized acute care criteria, federal and state mandates and regulatory body qualifications. Reports to Director, Care Management / Utilization Review. **COMPETENCIES AND SKILLS:** Demonstrates knowledge of payor practices and regulatory mandates. Demonstrates exceptional expertise to retrieve clinical details from medical chart/documentation. Demonstrates current expertise of 3rd party payers and pre-certification process. Demonstrates the expertise to review medical clinical documentation for sustained periods of time with high-level of concentration.