Utilization Review Coordinator jobs in Springfield, MO
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 Coordinator
- Perimeter Healthcare
-
Waynesville, MO
FULL_TIME
-
The Utilization Review Coordinator shall maintain an effective, efficient Utilization Review Program and oversees all functions related to admissions and case management.
ESSENTIAL DUTIES AND RESPONSIBILITIES include, but are not limited to, the following:- Demonstrates the ability to work closely with the Medical Director, Clinical Director, and all clinical staff to ensure that sufficient documentation is present to justify the clinical necessity and appropriateness of admission and continued stay.
- Demonstrates the ability to compile statistical reports and submit findings monthly to the required Committee.
- Demonstrates the ability to evaluate and recommend strategies to improve the efficiency with which services are provided and detect and eliminate under or over utilization.
- Demonstrates the ability to review cases with insurance/managed care companies/out-of-state entities to include pre-certification, admissions reviews, and continued stay reviews.
- Demonstrates the ability to work with Medical Records regarding documents sent to any insurance/managed care company.
- Demonstrates the ability to review charts on a daily basis, report any deficiencies to the appropriate staff, and assisting with getting those deficiencies corrected.
- Participates as an integral member of the treatment team including attendance and knowledge of scheduling of treatment team reviews, special case reviews, and treatment formulation. In addition, works with parents, guardians and family members to encourage active involvement in treatment of the resident and continuation of active insurance benefits.
- Attends meetings, prepares reports, and follows policy and procedures to include; patient rights, confidentiality, privacy and the code of ethics. Participates in performance improvement activities to include staff development and completes all required annual training.
- Demonstrates the ability to oversee the Discharge Planning process for each resident to ensure that the process is complete and timely.
- Demonstrates the ability to keep all information updated in the computer system regarding insurance authorizations and assists Corporate in any billing issues.
QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. An individual must be able to perform the duties in a positive work mode and serve as a positive role model and influence for youth and peers. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- AGE
- EDUCATION and/or EXPERIENCE
- Licensed RN or Bachelors Degree in the mental/behavioral health field required
- (1) year experience in the Utilization Review process and/or two (2) years clinical experience in a psychiatric facility preferred.
- Experience working in a children's services program or in a residential setting is preferred.
- Strong organizational skills, communication skills and ability to perform detailed work.
- Ability to use the English language and medical terminology effectively and to understand/carry out complex oral and written instructions within a prescribed routine.
- 27 Days Ago
Utilization Review Supervisor
- CoxHealth
-
Springfield, MO
FULL_TIME
- Summary Best in Class Work Environment 5x Modern Healthcare Best Places to work America’s Greatest Workplaces 2023 – Newsweek Best Employers for New Grads 2023- Forbes Greatest Workplace for Women 202...
- 7 Days Ago
Utilization Review Supervisor
- CoxHealth
-
Springfield, MO
FULL_TIME
- Summary Best in Class Work Environment 5x Modern Healthcare Best Places to work America’s Greatest Workplaces 2023 – Newsweek Best Employers for New Grads 2023- Forbes Greatest Workplace for Women 202...
- 7 Days Ago
Appraisal Review Specialist
- Legacy Bank and Trust
-
Springfield, MO
FULL_TIME
- Summary: Appraisal Review Specialist Availability: Monday – Friday 8:00am – 5:00pm - Springfield Perform reviews of either commercial or consumer appraisals to verify compliance with both USPAP and FI...
- 1 Day Ago
Medical Review Nurse
- Vital Signs
-
Solo, MO
FULL_TIME
- 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 we...
- 1 Day Ago
Paid Product Tester
- Product Review Jobs
-
Gamaliel, AR
FULL_TIME
- Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
- 1 Day Ago
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0 Utilization Review Coordinator jobs found in Springfield, MO area
Office Coordinator - CMS Ambulatory Infusion Center
- CoxHealth
-
Springfield, MO
- Summary Best in Class Work Environment * 5x Modern Healthcare Best Places to work * America's Greatest Workplaces 2023 -...
- 4/25/2024 12:00:00 AM
Dietitian for Elder Care
- Jordan Valley Community Health Center
-
Springfield, MO
- Job Summary Responsible for providing nutrition care and education to Jordan Valley Senior Care participants. Evaluate t...
- 4/25/2024 12:00:00 AM
Video Communications Administrator, Pharm D Program
- Missouri State University
-
Springfield, MO
- Posting Details Position Information Position Title Video Communications Administrator, Pharm D Program Work Location Sp...
- 4/25/2024 12:00:00 AM
Customer Sales & Service Representative I, Front Counter (Non-Retail)
- Mediacom Communications Corporation
-
Springfield, MO
- Position: Customer Sales & Service Representative I, Front Counter (Non-Retail) Who we are: Since 1995, Mediacom Communi...
- 4/24/2024 12:00:00 AM
Executive Administrative Assistant
- James River Church
-
Ozark, MO
- The Executive Assistant to the Senior Associate Pastor will serve as a member of the Lead Pastor’s administrative staff ...
- 4/23/2024 12:00:00 AM
Medical Receptionist
- U.S. Physical Therapy
-
Ava, MO
- Overview linic Name: ARC Physical Therapy+ Position: Medical Receptionist Location: Ava, Missouri Experience: 1+ Years E...
- 4/22/2024 12:00:00 AM
Administrative Assistant II-Library
- Missouri State University
-
Springfield, MO
- Posting Details Position Information Position Title Administrative Assistant II-Library Work Location Springfield Campus...
- 4/21/2024 12:00:00 AM
Academic Administrative Assistant II (Missouri State Outreach)
- Missouri State University
-
Springfield, MO
- Posting Details Position Information Position Title Academic Administrative Assistant II (Missouri State Outreach) Work ...
- 4/21/2024 12:00:00 AM
About Springfield, Missouri
Springfield is the third-largest city in the state of Missouri and the county seat of Greene County. As of the 2010 census, its population was 159,498. As of 2017, the Census Bureau estimated its population at 167,376. It is the principal city of the Springfield metropolitan area, which has a population of 462,369 and includes the counties of Christian, Dallas, Greene, Polk, Webster.
Springfield's nickname is "Queen City of the Ozarks" and it is known as the "Birthplace of Route 66". It is home to three universities, Missouri State University, Drury University, and Evangel University.
Springf...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$72,483 to $89,788
Springfield, Missouri area prices
were up 1.3% from a year ago
were up 1.3% 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