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)
Description
Full Time, Monday - Friday 8:00 a.m. - 4:30 p.m. This position has the potential to be remote upon completion of orientation. This individual should be able to attend in-person meetings on occasion.
Reporting to the Chief Financial Officer, The Utilization Review Nurse is responsible for the coordination of pre-authorization for services from third party insurers.
Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Other Job Functions
Requirements
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