Job Description
**It's more than a career, it's a calling**
MO-REMOTE
**Worker Type:**
Regular
**Job Highlights:**
Eligible candidates must reside within SSM Health's four state footprint - including Missouri, Illinois, Wisconsin or Oklahoma only.
**Job Summary:**
Evaluates the medical necessity and appropriateness of hospital admissions and surgical procedures. Ensures payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor.
**Job Responsibilities and Requirements:**
PRIMARY RESPONSIBILITIES
+ Discusses with payor regarding criteria and payor decision.
+ Escalates denials to physician (advisor, attending consultant, outside consultant) for peer to peer consideration.
+ Documents outcome in electronic medical record.
+ Participates with other members of team regarding opportunities for improvement in standard work.
+ Performs rev...
MO-REMOTE
**Worker Type:**
Regular
**Job Highlights:**
Eligible candidates must reside within SSM Health's four state footprint - including Missouri, Illinois, Wisconsin or Oklahoma only.
**Job Summary:**
Evaluates the medical necessity and appropriateness of hospital admissions and surgical procedures. Ensures payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor.
**Job Responsibilities and Requirements:**
PRIMARY RESPONSIBILITIES
+ Discusses with payor regarding criteria and payor decision.
+ Escalates denials to physician (advisor, attending consultant, outside consultant) for peer to peer consideration.
+ Documents outcome in electronic medical record.
+ Participates with other members of team regarding opportunities for improvement in standard work.
+ Performs rev...