Description

Job Description

Overview

Location: Methodist Hospital

Position: RCS - Clinical Specialist - Utilization Management

Shift: 1.0 Day Monday- Friday

IU Health is Indiana's largest and most comprehensive healthcare system, dedicated to delivering high-quality, compliant revenue cycle operations. We are seeking a dedicated Clinical Specialist to execute clinical team functions within Revenue Cycle Services, ensuring adherence to quality standards and regulatory compliance.

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Position Overview:

The RCS - Clinical Specialist is responsible for performing clinical functions within IU Health Revenue Cycle Services. The role ensures that work processes meet established quality standards, resulting in consistent outcomes aligned with federal, state, and hospital policies and procedures. The specialist facilitates accurate and timely patient-specific information in medical records, supporting compliance and optimal billing and coding activities. Demonstrating a commitment to IU Health's mission, vision, and values, the specialist aligns behaviors and results with the organization's strategic goals.

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Key Responsibilities:

• Execute clinical team functions within Revenue Cycle Services, ensuring compliance with documented standards.
• Support the collection and maintenance of accurate, timely patient-specific information in medical records to meet federal, state, and organizational requirements.
• Accept feedback from leadership to identify barriers and improve processes.
• Meet departmental productivity and quality standards consistently.
• Handle verbal and written communication effectively with team members and customers.
• Use experience and judgment to assemble and verify patient care and billing information, ensuring appropriate coding, billing, and cost outcomes.
• Maintain current knowledge of medical record requirements, regulations, and policies.
• Escalate questions, issues, and key decisions appropriately to support service quality and compliance.
• Demonstrate a commitment to IU Health's mission, vision, and values by exhibiting behaviors aligned with purpose, excellence, compassion, and teamwork.

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Qualifications & Requirements:

• Education:
  • Associate of Nursing (ASN) required.
  • Bachelor of Nursing (BSN) preferred.
• Licensure & Certifications:
  • Active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
  • Graduate from a nationally accredited nursing program.
• Experience & Skills:
  • Clinical work experience and familiarity with medical terminology.
  • Understanding of medical record requirements, regulations, and policies.
  • High interpersonal, problem-solving, and analytical skills.
  • Effective written and verbal communication skills in individual and group settings.
  • Ability to prioritize and manage multiple tasks simultaneously.
  • Proficiency with personal computers, including word processing and database software.
  • 1-3 years of Utilization Management experience Strongly Preferred

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Why Join IU Health?

• Comprehensive benefits package including health, dental, and vision insurance
• Retirement savings plan with employer match
• Tuition reimbursement and professional development opportunities
• Employee assistance programs and wellness initiatives
• Supportive work environment committed to safety and excellence

To learn more about our benefits, visit: careers.iuhealth.org/pages/benefits-designed-for-you

We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.