Utilization Review Coordinator jobs in Alabama
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
- Bradford Health Services
-
Warrior, AL
FULL_TIME
-
Position Title: Utilization Review Coordinator
Department: Administrative
Reports To: Executive / Program Director
Supervises: NA
Entry Level Qualifications
A current RN, LPC, LMFT, LMSW, or LCSW license preferred. Two years minimum experience in utilization review preferred. Must possess good grammatical and communication skills. Must be skilled in Microsoft Office applications and have a working knowledge of office equipment.- Must be able to read and comprehend hand-written, printed, and on-line treatment notes and plans.
- Must be able to hear and comprehend conversations and instructions.
- Must be able to continuously sit for approximately 7 hrs. per 8 hr. shift.
- Must be able to walk within the facility a total of approximately two (2) hrs. per day.
- If recovering, two years of continuous verifiable abstinence.
Complete coordination of the facilities insurance certification including precertification and continued stay reviews, as well as follow up on all insurance denials, appeals and reconsiderations.
Know and abide by the general provisions of 42 CFR Part 2, “Confidentiality of Drug and Alcohol Abuse Patient Records”, and 45 CFR “Health Insurance Portability and Accountability Act.” This position has unrestricted access to patient identifying and patient health information.
Essential Functions- Perform all pre admission certification reviews, continued stay reviews, appeals, denials and/or reconsiderations and provide
- Maintain an "UR Activity Log" which records every review for the facility with financial classification and U.R. information/activity.
- Maintain a "call back' calendar for continued stay reviews and maintain a U.R. file for each patient.
- Document, in the patient electronic record software, the review with the managed care organization, including the level of care
- Review and maintain all correspondence pertaining to certification, appeals, denials or reconsiderations, and ensure they are
- Complete all Quality Improvement indicators for Utilization Management, data analysis and reporting.
- Educate counseling staff regarding data needed to adequately document patient care and educate crisis staff regarding data
- Ability to work in a constant state of alertness as to perform the job safely.
- Ability to work in cooperative manner with co-workers, managers, clients and prospective managers.
- Regular attendance.
- Any other duties as assigned by supervisor.
- 13 Days Ago
Case Manager, Utilization Review
- Viva Health
-
Birmingham, AL
FULL_TIME
- VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is seeking a Case Manager, Utilization Review position to join our team in Birmingham, AL! VIVA HEALTH knows that nurs...
- 8 Days Ago
RN Case Manager (Utilization Review)
- Actalent
-
Florence, AL
OTHER
- Hiring a Utilization Review Case Manager for a great hospital FULLY REMOTE. Great culture and environment!MUST HAVE ACTIVE CA RN LICENSE, EPIC, AND INTERQUAL EXPERIENCE TO APPLY!!Description:This posi...
- 9 Days Ago
Salon Coordinator
- Sport Clips - Coordinator - AL507
-
Huntsville, AL
FULL_TIME
- Sport Clips is seeking a dynamic and enthusiastic Salon Coordinator to join our team and play a pivotal role in delivering exceptional customer service and ensuring the smooth operation of our salon. ...
- 24 Days Ago
Salon Coordinator
- Sport Clips - Coordinator - AL502
-
Huntsville, AL
FULL_TIME
- Sport Clips is seeking a dynamic and enthusiastic Salon Coordinator to join our team and play a pivotal role in delivering exceptional customer service and ensuring the smooth operation of our salon. ...
- 22 Days Ago
Clinical Review Coordinator NaviHealth Florence Alabama
- UnitedHealth Group
-
Florence, AL
FULL_TIME
- Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model ...
- 7 Days Ago
Utilization Review Coordinator jobs at Popular Companies
Utilization Review Coordinator
- TheraMatrix
-
Pontiac, MI
- Job Description Job Description Duties and Responsibilities: Initial authorizations of outpatient physical therapy servi...
- 6/2/2024 12:00:00 AM
Utilization Coordinator
- Tenderheart Health Outcomes
-
Austin, TX
- Job Description Job Description For nearly two decades, TenderHeart (formerly known as Longhorn Health Solutions) has be...
- 6/1/2024 12:00:00 AM
Utilization Review Coordinator (RN)
- Community Health System - CA
-
Fresno, CA
- Overview: *All positions are located in Fresno/Clovis CA* *Up to $25K in bonus incentives (sign-on and relocation)* Oppo...
- 5/31/2024 12:00:00 AM
Underground Utilities Supervisor
- Edgerton Contractors, Inc.
-
Oak Creek, WI
- Edgerton is a premier, earthmoving, and underground utility company. We seek out opportunities where our depth of experi...
- 5/31/2024 12:00:00 AM
Utility Supervisor
- StarPlus Energy
-
Kokomo, IN
- Company Overview: STARPLUS ENERGY LLC is an electrifying joint venture between Samsung and Stellantis. With a focus on i...
- 5/30/2024 12:00:00 AM
Utilization Coordinator
- Tenderheart Health Outcomes
-
Albany, NY
- Job Description Job Description For nearly two decades, TenderHeart (formerly known as Longhorn Health Solutions) has be...
- 5/29/2024 12:00:00 AM
Utilization Review Coordinator / Case Management / PRN
- Christus Health
-
Santa fe, NM
- Description POSITION SUMMARY: Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine t...
- 5/29/2024 12:00:00 AM
Utilization Review Coordinator (RN)
- Community Health System - CA
-
Fresno, CA
- Overview: *All positions are located in Fresno/Clovis CA* *Up to $25K in bonus incentives (sign-on and relocation)* Oppo...
- 5/21/2024 12:00:00 AM
About Alabama
Alabama (/ˌæləˈbæmə/) is a state in the southeastern region of the United States. It is bordered by Tennessee to the north, Georgia to the east, Florida and the Gulf of Mexico to the south, and Mississippi to the west. Alabama is the 30th largest by area and the 24th-most populous of the U.S. states. With a total of 1,500 miles (2,400 km) of inland waterways, Alabama has among the most of any state.
Alabama is nicknamed the Yellowhammer State, after the state bird. Alabama is also known as the "Heart of Dixie" and the "Cotton State". The state tree is the longleaf pine, and the state flower is...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$74,437 to $92,205
Most Popular Cities in Alabama for Utilization Review Coordinator Jobs
What does an Utilization Review Coordinator do?
Utilization Review Coordinator in Long Beach, CA
The Utilization Review Coordinator contributes to moderately complex aspects of a project.
January 05, 2020
Utilization Review Coordinator in Gary, IN
Candidates for this role must have a good understanding of medical terminologies, and stay tuned with latest developments in the field; they should possess knowledge of reviews such as MAC, KEPRO, and RAC; strong observing skills and the ability to monitor safety plans are also needed.
December 29, 2019
Utilization Review Coordinator in Chicago, IL
Including requirements, responsibilities, statistics, industries, similar jobs and job openings for Utilization Review Coordinator.
December 30, 2019