Utilization Review Coordinator jobs in Minneapolis, MN
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)
Recently Added Utilization Review Coordinator jobs
Utilization Review Analyst - Full Time
- NUWAY
-
Saint Paul, MN
FULL_TIME
-
Position OverviewThe Utilization Review Analyst will support the Utilization Review department which acts as a liaison between the clinical treatment team and third-party payers to promote appropriate treatment services, documentation practices and billing integrity for SUD treatment. The Utilization Review Department position ensures system integrity through the treatment continuum from clinical to claims management. Utilization Review Analysts work in a team environment and collaborate with each other to support the department’s responsibilities within NUWAY Alliance as well as other members of the team. This position will also work in conjunction with other departments within the organization to support improvement in the overall quality, completeness and accuracy of medical record documentation.This position allows for a hybrid workplace, utilizing a telecommute work environment. The Utilization Review Analyst must be able to maintain client confidentiality in accordance with state and federal guidelines and HIPAA requirements.Responsibilities
- Audit documentation across NUWAY Alliance programs to substantiate appropriate clinical documentation practices, inclusive of providing data and feedback to staff and leadership about patterns, trends and gap analysis
- Collaboration with Admissions and Clinical teams to identify clients entering treatment programming to determine funding
- Secure funding for client’s admitting into NUWAY Alliance programs and documents approved funding source with approval units and/or dates
- Complete documentation to support extension of funding for programming services, while reviewing medical necessity criteria
- Develop and maintain efficient processes related to client funding, including prior authorizations and concurrent reviews for third party payors
- Facilitate communication with Clinical teams to obtain appropriate clinical documentation to ensure that clinical documentation reflects the level of service rendered to clients is complete, accurate and medically necessary
- Communicate data related to insurance payers, denials and extension requests in a clear and timely manner
- Maintain current information about third party criteria for reimbursement and establish and maintain relations with payers to promote positive and direct communication
- Support all Medical Records Requests from third party payers
- Serve cross-functionally with Clinical teams, Leadership and Billing/Revenue Cycle teams, as well as other internal teams to assist in identification of overpayments
- Support the execution of internal controls to prevent issues with billing, documentation and other processes as applicable
- Maintain positive and open communications NUWAY Alliance staff, departments and leadership
- Conduct oneself in a manner that presents a positive reflection of professionalism, as an asset to the image of the organization
- Other duties as assigned or required
Competencies- Support the Clinical teams with regulation and standard implementation and understanding of the utilization review process
- Utilize clinical knowledge and licensure to support utilization review activities of the organization
- Understand and apply the importance of self-awareness in one’s personal, professional, and cultural life
- Provide services appropriate to the personal and cultural identity and language of the client and other professionals
- Understand the treatment modalities and clinical application to practice at NUWAY to support effective training resources
Qualifications, Skills, Knowledge and ExperienceRequired:- Bachelor’s degree with a major or concentration in a related field
- Current LADC license required
- Age 18 or older
- Clinical documentation integrity, clinical quality improvement, utilization review, discharge planning, or case management experience of at least one year
- At least 1 year of providing Substance Use services in an individual and group counseling setting
- Knowledge of ICD-10 and DSM-5
- Able to pass Minnesota DHS background study
- Must be free of problematic substance use for at least two years immediately preceding employment and must sign a statement attesting to that fact
- High degree of computer literacy including experience using an electronic health records (EHR) system
- Excellent written, communication, customer service, and case management skills
- Ability to relate to people from diverse backgrounds
- Demonstrated working knowledge in the field of substance use disorder and/or mental health, in an addiction treatment facility
- Physical Demands: Sitting for extended periods of time. Daily use of general office and/or residential facility equipment. Lifting (max 25 pounds), minimal reaching, bending and stooping. Ability to effectively navigate program or office environment such as ascending and descending steps, passing through doorways and entrances, and accessing program/office facilities.
Preferred:- Minimum of 1 year experience performing utilization review tasks
- Strong analytical and problem-solving skills
- Strong facilitation, negotiation, investigation and mediation skills
- 6 Days Ago
Review Coordinator
- MN Adult & Teen Challenge
-
Minneapolis, MN
FULL_TIME
- Job Summary The Review Coordinator will collaborate and partner with the assessment team to assist in the admission and referral process for clients applying to short-term, long-term or outpatient tre...
- 1 Month Ago
Salon Coordinator
- Sport Clips - Coordinator - MN120
-
Shoreview, MN
FULL_TIME
- Job Title: ️ Salon Coordinator Extraordinaire Wanted at Sport Clips! Company: Sport Clips Location: Shoreview, MN About Us: Sport Clips is on the hunt for a dynamic and enthusiastic Salon Coordinato...
- 1 Month Ago
Salon Coordinator
- Sport Clips - Coordinator - MN122
-
Excelsior, MN
FULL_TIME
- Job Title: ️ Salon Coordinator Extraordinaire Wanted at Sport Clips! Company: Sport Clips Location: Excelsior, MN About Us: Sport Clips is on the hunt for a dynamic and enthusiastic Salon Coordinato...
- 1 Month Ago
Salon Coordinator
- Sport Clips - Coordinator - MN128
-
Minnetonka, MN
FULL_TIME
- Job Title: ️ Salon Coordinator Extraordinaire Wanted at Sport Clips! Company: Sport Clips Location: Minnetonka, MN About Us: Sport Clips is on the hunt for a dynamic and enthusiastic Salon Coordinat...
- 1 Month Ago
Salon Coordinator
- Sport Clips - Coordinator - MN135
-
Saint Louis, MN
FULL_TIME
- Job Title: ️ Salon Coordinator Extraordinaire Wanted at Sport Clips! Company: Sport Clips Location: St. Louis Park, MN About Us: Sport Clips is on the hunt for a dynamic and enthusiastic Salon Coord...
- 1 Month Ago
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0 Utilization Review Coordinator jobs found in Minneapolis, MN area
Front Desk Administrative Assistant
- Bell International Laboratories
-
Minneapolis, MN
- Job Description Job Description Position Overview: As the Front Desk Administrative Assistant, you play a pivotal role i...
- 4/18/2024 12:00:00 AM
Order Intake Coordinator (Contract Role - Hybrid M-F 8AM-4:30PM)
- Tactile Systems Technology, Inc.
-
Minneapolis, MN
- Overview The Order Intake Coordinator is responsible for processing all patient related paperwork for the sales team. Th...
- 4/18/2024 12:00:00 AM
Public Assistance Disaster Recovery – Program Delivery Manager (PDMG) – Project Manager
- AECOM
-
Minneapolis, MN
- **Company Description** **How will you make your mark?** At AECOM, our work in providing access to clean water enables c...
- 4/18/2024 12:00:00 AM
Business Coordinator - MTM (Remote)
- Fairview Health Services
-
Saint Paul, MN
- Overview: Are you looking to further your business experience in the health care field? We at MHealth Fairview are looki...
- 4/18/2024 12:00:00 AM
LADC - Peer Specialist Supervisor
- Kyros
-
Minneapolis, MN
- Who is Kyros? Kyros is a venture-backed Minneapolis-based start-up that is revolutionizing the way that recovery service...
- 4/17/2024 12:00:00 AM
Administrative Assistant
- Bell International Laboratories
-
St Paul, MN
- Position Overview: As the Front Desk Administrative Assistant, you play a pivotal role in supporting Bell and/or Manager...
- 4/17/2024 12:00:00 AM
Utility Maintenance Supervisor - Water Production
- City of Eagan, MN
-
Saint Paul, MN
- Salary: $99,536.00 - $126,089.00 Annually Location : City of Eagan Job Type: Full-Time Job Number: 202400166 Department:...
- 4/15/2024 12:00:00 AM
Administrator
- Estates at Lynnhurst
-
Saint Paul, MN
- Estates at Lynnhurst - Administrator POSITION SUMMARY The Administrator is accountable for the management, control and o...
- 4/15/2024 12:00:00 AM
About Minneapolis, Minnesota
Minneapolis (/ˌmɪniˈæpəlɪs/ (listen)) is the county seat of Hennepin County and the larger of the Twin Cities, the 16th-largest metropolitan area in the United States. As of 2017, Minneapolis is the largest city in the state of Minnesota and 45th-largest in the United States, with an estimated population of 422,331. The Twin Cities metropolitan area consists of Minneapolis, its neighbor Saint Paul, and suburbs which altogether contain about 3.6 million people, and is the third-largest economic center in the Midwest.
Minneapolis lies on both banks of the Mississippi River, just north of the riv...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$85,545 to $105,968
Minneapolis, Minnesota area prices
were up 1.4% from a year ago
were up 1.4% from a year ago
What does an Utilization Review Coordinator do?
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