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)
100% Remote, Work-From-Home position anywhere in the US. (Any state RN license is accepted).
As an RN, you will provide direction, guidance, and support to our physician Medical Claims Reviewers as well as other staff as indicated. Complete quality audits of individual case reviews.
Support the clinical aspects of the review process and case reviews, including but not limited to:
Qualifications:
Clear All
0 Utilization Review Coordinator jobs found in Lansing, MI area