Utilization Reviewer

RHI Rehab•Indianapolis, IN

1d•Onsite

About The Position

The Rehabilitation Hospital of Indiana (RHI) is nationally ranked among the Best Hospitals for Rehabilitation by U.S. News and World Report for 2025-2026 and the Best Rehabilitation Hospital in Indiana for the third year in a row. RHI provides high quality, evidence-based rehabilitation services to those facing life-changing injuries or illness. We specialize in the areas of brain injury, stroke, spinal cord injury and complex medical conditions. We offer inpatient and outpatient rehabilitation services to patients 15 years of age and older. RHI is the only Traumatic Brain Injury (TBI) Model System in the state of Indiana and one of only 16 in the U.S We offer a competitive compensation and benefits package, along with a 401k match and tuition reimbursement program. Summary: The Utilization Reviewer contributes to assessment and planning by performing a thorough review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful transition to the discharge setting and or goal achievement, and durability of outcome.

Requirements

Greater than 2 years of UR experience with a strong clinical background and competence with a rehabilitation population.
Bachelor's degree in related field with 3-5 years' experience
LPN or RN experience preferred

Responsibilities

Assesses all of patient's payer sources for rehabilitation course, determines resources available for patient, and ensures maximal use of available health coverage resources for each patient.
Completes pre-certification and prior authorization timely for admission and or services.
Documents all insurance information appropriately on forms and in computer system as applicable.
Functions as liaison with payer representatives to manage the rehabilitation process in keeping with the patient's financial resources, including verification of benefits for this and future settings.
Completes retro authorizations as applicable and ensures follow through relative to authorizations for all services through the complete revenue cycle.
Other duties as assigned.