Revenue Utilization Review Nurse

The Revenue Utilization Review (RUR) Registered Nurse is under the supervision of a Nurse Manager, Assistant Nurse Manager, or designee, who provides the administrative and clinical supervision and general instruction, plans and assigns work, assigns time schedules, approves leave, performs quality reviews, coordinates internal control audits, and completes performance evaluations. The RUR Nurse is responsible for being self-directed in the delivery of revenue reimbursement processes and under moderate supervision and instruction by the registered nurse manager. Responsibilities of the RUR nurse include, but are not limited, to the following: Serves as a patient advocate providing accurate and timely clinical information to third-party payers. Ensures compliance with established third-party payer criteria for reimbursement and appeal of clinical denials. Provides feedback as appropriate, for performance improvement, utilization management, and compliance related issues. Conducts precer