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)
JOB DESCRIPTION
The Utilization Review Technician offers administrative support to UR staff. The URT is responsible for a broad range of utilization review support services to ensure efficient authorization coordination, including communicating between inpatient registration (IP Reg), revenue cycle operations (RCO), and clinical departments to ensure successful financial throughput of hospital encounters. The URT is responsible for securing authorizations for encounters in preparation for additional stages of the billing process. The URT performs follow-up activities and identifies medical reimbursement issues affecting outstanding hospital accounts.
EDUCATION & EXPERIENCE
Minimum Qualifications:
Preferred Qualifications:
Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.
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