Utilization Review Coordinator jobs in Chicago, IL

Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Being a Utilization Review Coordinator reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Coordinator consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). The Utilization Review Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Utilization Review Coordinator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)

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Utilization Review Coordinator Temp
  • Carolina Therapeutic Services
  • Chicago, IL FULL_TIME
  • Description

    CTS Health Services is a community mental health services center that specializes in a holistic approach to health and wellness for children, parents, and adults of varying circumstances and mental challenges. We provide one-on-one behavioral interventions for our clients and their support circles to help our clients navigate through life within their community at their highest level.


    The Utilization Review Coordinator's primary function is utilization management, conducting utilization review of initial authorizations and concurrent authorizations for new and existing persons referred, requesting, or actively receiving services. This position also reviews authorizations for all Levels of Care (LOCs) and services. The Utilization/Risk Management department will also conduct perspective, concurrent, and retrospective reviews for authorization of LOCs/services for individuals, conducts reviews using clinical information submitted by Program Managers, direct contact with staff and insurance companies, review of medical necessity records, and contact with the individual and family members when needed. Another function of the Utilization/Risk Management department is also to review and process all billing (including EOB) claims and payroll functions for CTS Health, Inc. in coordination with the agency’s finance team. Staff members must maintain reports/trackers that are supplied to their supervisors or other Executive Team Members as requested.


    ** This role is temporary role with a possibility of converting to permanent at a later time.


    Responsibilities of Utilization Review Coordinator, not limited to:

    • Submit Initial and Concurrent Authorizations to MCOs for assigned contract areas
    • Document work on all trackers (upcoming due dates, units etc.) supplied by supervisor and submit to necessary parties as required by supervisor
    • Verify client insurance coverage for authorization submission
    • Coordinate with MCO to resolve any billing or authorization issues as needed
    • Communicate all Billing and Payroll questions from Program Managers (by way of telephone and follow up email) and continually communicate this information with supervisor and CFO.
    • Compare and review all Service Verification Forms and Time sheets to ensure precise process of all Payroll for designated state
    • Communicate with program managers that all documentation is accurate and complete prior to billing claims for all individuals.
    • Ensure all claims billed have supporting documentation to support service.
    • Requests support documentation from program managers as needed.
    • Report critical concerns and problems to Supervisor in a timely manner and actively seek Supervisor’s input and assistance to resolving the concern.
    • Participant in state and local audits.
    • Abide by and implement all the policies, procedures, regulations, and standards that govern the agency.
    • Maintains strict confidentiality according to all Federal and State guidelines and requirements.
    • Exemplifies personal and professional conduct.
    • Upholds the Professional Code of Ethics.
    • Maintains a cooperative relationship with employees, medical staff and others.
    • Demonstrates tact, courtesy, and a positive approach to communication and interaction with other employees, visitors, physicians, etc.
    • Work with a team approach with other employees to ensure efficacy of care for ALL Consumers.
    • Follow chain of command when encountering problems?or other areas of need and correct problems?requested.
    • Actively participate in an appropriate manner with the decision-making process as “pro-active” team member and cooperate with team’s decision, whether programmatic or clinical.
    • Attend staff meetings, planned in-service training and any other regular or assigned meetings.
    • Perform other required job duties that the supervisor and/or director require to maintain continuity of care for consumers and profitability for the agency.

    Requirements

    Requirements of the Utilization Review Coordinator

    • High School Diploma or GED, required
    • Must be at least 18 years of age, be able to read, write and effect both written and verbal communication successfully;
    • Understand and follow directions.
    • Possess no substantiated findings of abuse or neglect listed on Health Care Registry, and no criminal convictions.
    • At least 1 year epxerience of utilization management/review
  • 20 Days Ago

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Utilization Review Coordinator
  • Chicago Behavioral Hospital
  • Des Plaines, IL OTHER
  • Job Details Job Location: Chicago Behavioral Hospital - Des Plaines, IL Position Type: Full Time Education Level: Graduate Degree Salary Range: $56,000.00 - $65,000.00 Job Shift: Day DescriptionChicag...
  • 22 Days Ago

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Utilization Review Coordinator
  • 2014 HEALTH LLC CHICAGO BEHAVIORAL HOSPITAL
  • Des Plaines, IL OTHER
  • Job Details Job Location: Chicago Behavioral Hospital - Des Plaines, IL Position Type: Full Time Education Level: Graduate Degree Salary Range: $56,000.00 - $65,000.00 Job Shift: Day DescriptionChicag...
  • 1 Month Ago

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0474 - SHS UTILIZATION REVIEW COORDINATOR
  • Sinai Chicago
  • Chicago, IL FULL_TIME
  • About Sinai Health System Located on Chicago’s West and Southwest Side, Sinai Health System is comprised of Mount Sinai Hospital, Holy Cross Hospital, Schwab Rehabilitation Hospital, Sinai Children’s ...
  • 23 Days Ago

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Utilization Review Coordinator - Full Time
  • UHS
  • CHICAGO, IL FULL_TIME
  • Responsibilities JOB SUMMARY: Performs timely, daily clinical reviews with all payer types, to secure authorization for initial and continued treatment based on payer’s criteria and in accordance with...
  • 10 Days Ago

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Health Care Utilization Review Coordinator - Continuum of Care
  • University of Illinois Hospital
  • Chicago, IL OTHER
  • Position SummaryHealth Care Utilization Review Coordinator (HURC) is accountable for coordinating and facilitating patient services across the various levels of the continuum utilizing Relationship-Ba...
  • 2 Months Ago

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0 Utilization Review Coordinator jobs found in Chicago, IL area

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Utility Worker
  • Transdevna
  • Chicago, IL
  • Hiring Immediately! Transdev Services, Inc., is seeking a Utility Worker at its 615 W 41st Street, Chicago, IL 60609 loc...
  • 3/28/2024 12:00:00 AM

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Special Assistant to the President (Public Affairs)
  • Interfaith America
  • Chicago, IL
  • Job Type Full-time Description ABOUT US: Interfaith America is a national nonprofit organization based in Chicago. We be...
  • 3/28/2024 12:00:00 AM

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Administrative Coordinator-Telestroke Program Full-Time Days
  • Northwestern Medicine
  • Chicago, IL
  • Benefits * $10,000 Tuition Reimbursement per year ($5,700 part-time) * $10,000 Student Loan Repayment ($5,000 part-time)...
  • 3/28/2024 12:00:00 AM

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Technical Project Manager
  • KDM Engineering
  • Chicago, IL
  • Why Choose KDM? KDM Engineering was founded in 2012 on a promise to alter the face of the engineering field. Today, we'r...
  • 3/27/2024 12:00:00 AM

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Resident Engineer
  • Pinpoint Precision
  • Chicago, IL
  • Pinpoint Precision Engineering is a dynamic and growing minority-owned company, seeking a Resident Engineer with experie...
  • 3/27/2024 12:00:00 AM

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Civil Engineer II
  • Pinpoint Precision
  • Chicago, IL
  • Job Description Job Description Boost your career with Pinpoint Precision Engineering! Having an exceptional company cul...
  • 3/27/2024 12:00:00 AM

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Civil Engineer Designer
  • PDF ENGINEERING
  • Chicago, IL
  • Job Description Job Description CIVIL ENGINEER DESIGNER PDF Engineering is a civil engineering firm providing constructi...
  • 3/27/2024 12:00:00 AM

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Housing and Residence Life Coordinator
  • Art Institute of Chicago
  • Chicago, IL
  • Housing and Residence Life Coordinator Residence Life For more than 150 years, the School of the Art Institute of Chicag...
  • 3/24/2024 12:00:00 AM

Chicago (/ʃɪˈkɑːɡoʊ/ (listen), locally also /-ˈkɔː-/), officially the City of Chicago, is the most populous city in Illinois, as well as the third most populous city in the United States. With an estimated population of 2,716,450 (2017), it is the most populous city in the Midwest. Chicago is the principal city of the Chicago metropolitan area, often referred to as Chicagoland, and the county seat of Cook County, the second most populous county in the United States. The metropolitan area, at nearly 10 million people, is the third-largest in the United States, and the fourth largest in North A...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$85,099 to $105,408
Chicago, Illinois area prices
were up 0.8% from a year ago

Utilization Review Coordinator in Fort Lauderdale, FL
Some review coordinator positions require that professionals have training and experience within a more specific field.
January 10, 2020
Utilization Review Coordinator in Asheville, NC
Schick Shadel Hospital is seeking a part-time (20 hours per week) Utilization Review Coordinator (UR Coordinator) to help oversee and perform the process of utilization review to ensure appropriate reimbursement by third party payers.
January 04, 2020
Utilization Review Coordinator in Jacksonville, FL
Excellent benefits, pay, small on-site employee gym, wonderful co-workers and managersFull Review.
January 04, 2020