Suzanne Rivera Email & Phone Number

New York, United States

• Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards.
• Reviewed and completed 15-20 cases per day.
• Performed admission reviews for medical necessity based upon CPT/ICD-10 codes and Interqual and Millman Care Guideline specifications
• Evaluated patient histories, complaints, and current symptoms.
• Evaluated medical necessity documentation to support the appropriate level of care for patients.
• Mitigated potential delays in service delivery through proactive identification of potential roadblocks within the precertification process.

New York, NY

Concurrent Review, Discharge planning for Subacute/Acute Rehabilitation and Skilled Nursing levels of care. Reviewed a census of approximately 30-35 cases on an ongoing basis following patients through entire length of stay, ensuring that facilities maintained appropriate levels of care. Collaborated with plan Medical Directors via weekly rounds and other.