Utilization Review Technician jobs in Scranton, PA

Utilization Review Technician 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 Technician 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 Technician consults with nurses and physicians as needed. Position is non-RN. May require an associate degree or its equivalent. Typically reports to a supervisor. May require Registered Health Information Technician (RHIT). The Utilization Review Technician gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Utilization Review Technician typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Utilization Review Specialist
  • Moriah Health
  • Kingston, PA FULL_TIME
  • SUMMARY: The UR Specialist is responsible for using their clinical knowledge and/or nursing experience, the review of preauthorization and concurrent review requests for all levels of care. Must collaborate with clinical and admissions staff to gather necessary information for thorough pre-authorizations and concurrent reviews.

    DUTIES AND RESPONSIBILITIES:

    • Using clinical knowledge and/or nursing experience, the Utilization Specialist reviews provider requests for inpatient and outpatient services, works closely with providers to collect all information necessary to perform a thorough medical necessity review.
    • Completes Peer reviews as necessary and or assisting in Peer reviews and Live Appeals with the appropriate person.
    • Participates in treatment team meetings, review client charts, complete requests for Single Case Agreements (SCA’s) or Letters of Agreement (LOA’s) with out of network insurance providers.
    • Write appeals, carry a caseload, and communicate interdepartmentally regarding insurance denials.
    • The role requires advanced understanding of clinical terminology, the ability to build rapport, and a strong grasp of medical necessity criteria.

    QUALIFICATIONS:

    • Bachelor’s in business administration or healthcare preferred
    • Previous utilization review experience in healthcare related fields with customer service experience

    Job Type: Full-time

    Pay: From $30,000.00 per year

    Benefits:

    • Dental insurance
    • Employee assistance program
    • Employee discount
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • Day shift
    • Monday to Friday

    Experience:

    • Utilization review: 1 year (Required)

    Work Location: In person

  • 12 Days Ago

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Utilization Review Nurse
  • Berkshire Hathaway GUARD Insurance Companies
  • Wilkes Barre, PA FULL_TIME
  • Overview Utilization Review Nurse Berkshire Hathaway GUARD Insurance Companies, an A Superior rated Insurance company is seeking a Utilization Review Nurse who is interested in joining a company with ...
  • 1 Month Ago

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Skilled Electrical and Controls Technician
  • Procter & Gamble | Plant Technician
  • Mehoopany, PA OTHER
  • Electrical and Controls technicians are being hired as skilled members of our manufacturing operations teams. Electrical and Controls technicians are responsible for enabling production throughput, re...
  • 1 Month Ago

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Paid Product Tester
  • Product Review Jobs
  • POYNTELLE, PA 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...
  • Just Posted

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Paid Product Tester
  • Product Review Jobs
  • MILANVILLE, PA 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...
  • Just Posted

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Paid Product Tester
  • Product Review Jobs
  • EQUINUNK, PA 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...
  • Just Posted

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0 Utilization Review Technician jobs found in Scranton, PA area

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Pharmacy Technician & Technician Trainee>
  • Rite Aid Corp.
  • Carbondale, PA
  • Rite Aid Corp. - 54 North Main Street [Pharmacy Tech] As a Pharmacy Technician at Rite Aid Corp., you'll: Maintain the c...
  • 3/28/2024 12:00:00 AM

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Manufacturing Technician
  • Procter & Gamble
  • Dickson City, PA
  • Job Location Mehoopany Job Description Are you ready to gain new skills to help run and maintain the latest production t...
  • 3/28/2024 12:00:00 AM

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Pharmacy Technician & Technician Trainee
  • Rite Aid
  • White Haven, PA
  • Pharmacy TechnicianTechnician in Training Contribute to our mission to improve Health and Wellness in your community. Be...
  • 3/28/2024 12:00:00 AM

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Pharmacy Technician & Technician Trainee
  • Rite Aid
  • Scranton, PA
  • Pharmacy TechnicianTechnician in Training Contribute to our mission to improve Health and Wellness in your community. Be...
  • 3/27/2024 12:00:00 AM

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Electronics Technician
  • StarrTrax
  • Duryea, PA
  • Job Description Job Description ROLE: Electronics Technician ATTRACTIVE SKILLS/EXPERIENCES: Associates Degree in Electro...
  • 3/27/2024 12:00:00 AM

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Fabrication Technician
  • Kuharchik Construction
  • Scranton, PA
  • Job Description Job Description Job Summary: The Fabrication Technician will make repairs to metal, plastic, and fibergl...
  • 3/26/2024 12:00:00 AM

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MAINTENANCE TECHNICIAN
  • Berry Global, Inc
  • Pittston, PA
  • Overview: Berry Global, headquartered in Evansville, Indiana, is committed to its mission of Always Advancing to Protect...
  • 3/26/2024 12:00:00 AM

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Pharmacy Technician>
  • Community Health Systems
  • Scranton, PA
  • Community Health Systems - JobID: 2325db1a-2070-4ffd-aa82-87b7aacf489f [Pharmacy Tech] As a Pharmacy Tech at CHS, you'll...
  • 3/25/2024 12:00:00 AM

Scranton is the sixth-largest city in the Commonwealth of Pennsylvania. It is the county seat and largest city of Lackawanna County in Northeastern Pennsylvania's Wyoming Valley and hosts a federal court building for the United States District Court for the Middle District of Pennsylvania. With a population of 77,291, it is the largest city in the Scranton–Wilkes-Barre–Hazleton, PA Metropolitan Statistical Area, which has a population of about 570,000. The city is conventionally divided into 7 districts: North Scranton, Southside, Westside, East Scranton (Hill Section), Central City, Minooka, ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Technician jobs
$58,261 to $81,295
Scranton, Pennsylvania area prices
were up 1.5% from a year ago

Utilization Review Technician in Winston Salem, NC
When considering cost of living, this places Durham, NC as 3rd out of the 4 largest nearby metros in terms of quality of life for Utilization Review Technicians**.
January 02, 2020
Utilization Review Technician in Fairbanks, AK
Current National Pharmacy Technician Certification (PTCB, ExCPT or NCCT) required.
February 03, 2020
Utilization Review Technician in Little Rock, AR
Based on our compensation data, the estimated salary potential for Utilization Review Technician will increase 16 % over 5 years.
February 07, 2020