Job SummaryPerforms and ensures adherence to state, federal and third party payer certification requirements for initial, concurrent and retrospective medical record review for medical necessity and level of care determination.Job DutiesPerforms and ensures adherence to state, federal and third party payer certification requirements for initial, concurrent and retrospective medical record review for medical necessity and level of care determination.Identifies and notifies appropriate staff regarding discrepancy issues with third party payer health insurance coverage and lack of coverage.Maintains a working knowledge of third party payer health plans, working knowledge of nationally recognized review criteria and its application and state and