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)
Hours: M-F 8a-4:30p NO Remote Work
WeCare is actively seeking a Utilization Review Advocate. This vital role is central to our commitment to delivering exceptional care and support. The ideal candidate will be responsible for overseeing various aspects of utilization management, ensuring adherence to service standards, and collaborating across departments to promote efficient, person-centered care. A key component of this role includes the management of billing reviews and the diligent follow-up on claims denials.
Duties to include:
Requirements: