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Chart Utilization Review Jobs (NOW HIRING)

UHS

Utilization Review Coordinator

West Columbia, SC · On-site

Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written communication skills required in order to communicate in a clear and ...

UHS

Utilization Review Coordinator

West Columbia, SC · On-site

Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written communication skills required in order to communicate in a clear and ...

UHS

Utilization Review Coordinator

West Columbia, SC · On-site

Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written communication skills required in order to communicate in a clear and ...

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How much do chart utilization review jobs pay per hour?

As of Jun 6, 2026, the average hourly pay for chart utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Chart Utilization Review specialist, and why are they important?

To thrive as a Chart Utilization Review specialist, you need a background in healthcare, strong knowledge of medical terminology, and experience with patient care documentation, often supported by an RN or LPN license. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately reviewing charts and collaborating with healthcare providers. These abilities ensure compliance, optimize patient care, and support cost-effective healthcare delivery.

What is Chart Utilization Review?

Chart Utilization Review is a process commonly used in healthcare settings to assess the necessity, appropriateness, and efficiency of medical services provided to patients. It involves reviewing patient charts and medical records to ensure that treatments and procedures are justified according to established guidelines and policies. This process helps in improving patient care, managing costs, and ensuring compliance with regulatory requirements. Utilization review professionals work closely with medical staff, insurance companies, and regulatory agencies to support quality and cost-effective care.

What are some common challenges faced by professionals in Chart Utilization Review, and how can they be addressed?

Professionals in Chart Utilization Review often encounter challenges such as navigating incomplete or inconsistent medical documentation, staying current with ever-evolving healthcare regulations, and balancing productivity with accuracy. To address these challenges, it is important to maintain open communication with clinical staff, participate in ongoing training, and utilize robust electronic health record systems. Additionally, collaborating closely with interdisciplinary teams can help clarify documentation and ensure compliance with regulatory standards.

What is the difference between Chart Utilization Review vs Chart Review Specialist?

AspectChart Utilization ReviewChart Review Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires medical or coding certifications
Work EnvironmentHealthcare facilities, insurance companies, utilization management teamsMedical offices, insurance companies, coding firms
Employer & IndustryHospitals, insurance providers, healthcare organizationsMedical billing companies, insurance firms, healthcare providers
Primary FocusAssessing medical necessity and appropriateness of servicesReviewing medical records for coding accuracy and completeness

While both roles involve reviewing medical information, Chart Utilization Review focuses on evaluating the necessity of healthcare services, whereas Chart Review Specialists primarily verify medical documentation for coding and billing accuracy. Understanding these distinctions helps professionals choose the right career path or job search focus.

More about Chart Utilization Review jobs
What cities are hiring for Chart Utilization Review jobs? Cities with the most Chart Utilization Review job openings:
What states have the most Chart Utilization Review jobs? States with the most job openings for Chart Utilization Review jobs include:
What job categories do people searching Chart Utilization Review jobs look for? The top searched job categories for Chart Utilization Review jobs are:
Chart Utilization Review jobs near you
Infographic showing various Chart Utilization Review job openings in the United States as of May 2026, with employment types broken down into 94% Full Time, 2% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Specialist

Staffosaurus

Boynton Beach, FL • Hybrid

$65K - $80K/yr

Full-time

Medical, Dental, Vision

This job post has expired today. Applications are no longer accepted.

Job description

Utilization Review Specialist

Boynton Beach, Florida, United States Or refer someone Job Openings Utilization Review Specialist

Utilization Review Specialist

Join Our Team:

As a Utilization Review Specialist, you will play a pivotal role in managing and performing various processes related to medical records requests, retrospective review requests, and chart appeals. If you are organized, efficient, and dedicated to maintaining the highest standards of quality in medical records management, we invite you to join us in our mission.

Benefits:

  • Competitive salary commensurate with experience
  • Comprehensive health, dental, and vision insurance plans
  • Professional development opportunities
  • Supportive and positive work culture
  • Opportunities for career advancement

Utilization Review Specialist Requirements:

  • LMSW, LMHC, LPC, or other healthcare-related credentials or experience preferred.
  • Knowledge of behavioral health systems and various medical record platforms.
  • Two years of experience in a hospital or healthcare insurance setting required.
  • Bachelor's degree from an accredited college or university in social work, mental health, nursing, or a related degree required.

Utilization Review Specialist Responsibilities:

  • Manage and perform processes for medical records requests, retrospective review requests, and chart appeals.
  • Review medical records for any quality issues before submission.
  • Communicate with Supervisor and Quality Care team for assistance in meeting requests.
  • Prepare and distribute medical records to comply with payor requests, medical record reviews/requests, pre/post payment documentation requests, and chart appeals.
  • Prepare cover letters and chart appeal letters for medical necessity and claim denials.
  • Timely communicate outcomes, follow-up instructions, options, and related information to relevant administrative staff. Respond to all calls and emails within one business day unless otherwise required.
  • Document activity in Billing, UR software, and other approved locations.
  • Organize and file documents for ease of access in approved locations.
  • Communicate with Utilization Review team, Billing, Collections, and Verifications departments as needed for information relevant to medical records.
  • Assist in compiling information for data analysis.
  • Provide assistance in determining the likelihood of insurances covering treatment.
  • Maintain patient confidentiality in accordance with state and federal law.
  • Participate in internal information meetings, required in-service education and training, and company-wide performance improvement and compliance activities.
  • Perform other duties as assigned.

Pay: $65,000-$80,000 per year

Schedule: Hybrid M-F 9am-5pm

Location: Boynton Beach, Florida

Apply today! Or refer someone

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