The Utilization Management Coordinator will report to the Director of Utilization Review and will ... chart information to determine the patient's aftercare needs. * Coordinates with physician ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will ... chart information to determine the patient's aftercare needs. * Coordinates with physician ...
Case Manager
San Angelo, TX · On-site
$19.50 - $25.25/hr
Performs Utilization Review accurately and refers cases appropriately for secondary review ... the chart and documents. * Provides adequate communication of relevant issues to the ...
Case Manager
San Angelo, TX · On-site
$19.50 - $25.25/hr
Performs Utilization Review accurately and refers cases appropriately for secondary review ... the chart and documents. * Provides adequate communication of relevant issues to the ...
Case Manager
$19.50 - $25.25/hr
Performs Utilization Review accurately and refers cases appropriately for secondary review ... the chart and documents. * Provides adequate communication of relevant issues to the ...
Case Manager
$19.50 - $25.25/hr
Performs Utilization Review accurately and refers cases appropriately for secondary review ... the chart and documents. * Provides adequate communication of relevant issues to the ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short ...
Occupational Therapist - Physical Therapy
Texarkana, TX · On-site
$37.25 - $49.25/hr
Participates in medical chart peer review, case record review and utilization review as deemed necessary. * Assumes responsibility for therapeutic equipment safety, operation and maintenance.
Occupational Therapist - Physical Therapy
Texarkana, TX · On-site
$37.25 - $49.25/hr
Participates in medical chart peer review, case record review and utilization review as deemed necessary. * Assumes responsibility for therapeutic equipment safety, operation and maintenance.
Participates in medical chart peer review, case record review and utilization review as deemed necessary. * Assumes responsibility for therapeutic equipment safety, operation and maintenance.
Participates in medical chart peer review, case record review and utilization review as deemed necessary. * Assumes responsibility for therapeutic equipment safety, operation and maintenance.
Participates in medical chart peer review, case record review and utilization review as deemed necessary. * Assumes responsibility for therapeutic equipment safety, operation and maintenance.
Participates in medical chart peer review, case record review and utilization review as deemed necessary. * Assumes responsibility for therapeutic equipment safety, operation and maintenance.
Certified Occupational Therapist Assistant - Physical Therapy
Texarkana, TX · On-site
$26.50 - $35.25/hr
Participates in medical chart peer review, case record review and utilization review as deemed necessary. * Assumes responsibility for therapeutic equipment safety, operation and maintenance.
Certified Occupational Therapist Assistant - Physical Therapy
Texarkana, TX · On-site
$26.50 - $35.25/hr
Participates in medical chart peer review, case record review and utilization review as deemed necessary. * Assumes responsibility for therapeutic equipment safety, operation and maintenance.
Chart Utilization Review information
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?
| Aspect | Chart Utilization Review | Chart Review Specialist |
|---|---|---|
| Credentials | Typically requires healthcare or insurance-related certifications | Often requires medical or coding certifications |
| Work Environment | Healthcare facilities, insurance companies, utilization management teams | Medical offices, insurance companies, coding firms |
| Employer & Industry | Hospitals, insurance providers, healthcare organizations | Medical billing companies, insurance firms, healthcare providers |
| Primary Focus | Assessing medical necessity and appropriateness of services | Reviewing 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.
What are popular job titles related to Chart Utilization Review jobs in Texas? For Chart Utilization Review jobs in Texas, the most frequently searched job titles are:
- Per Diem Utilization Review Nurse
- Night Utilization Review Nurse
- Manager Utilization Management
- Weekend Physician Advisor Utilization Review
- Overnight Utilization Review Nurse
- Evening Utilization Review Nurse
- Flexible Cvs Utilization Management Nurse
- Part Time Utilization Review Nurse
- Remote Chart Review Nurse
- Remote Utilization Management Nurse
What job categories do people searching Chart Utilization Review jobs in Texas look for? The top searched job categories for Chart Utilization Review jobs in Texas are:
- Nurse Practitioner Utilization Review
- Overnight Remote Utilization Review
- Medical Utilization Review Physician
- Remote International Utilization Review Nurse
- Cigna Utilization Review Nurse
- Remote Cigna Utilization Review Nurse
- Weekend Utilization Review
- Flexible Cigna Utilization Review Nurse
- Part Time Utilization Review Manager
- Utilization Review Nurse Compact License
What cities in Texas are hiring for Chart Utilization Review jobs? Cities in Texas with the most Chart Utilization Review job openings:
Utilization Management Coordinator- Fulltime
Houston, TX • On-site
Other
Medical, Dental, Vision, Retirement
Posted 19 days ago
Job description
Houston Behavioral Healthcare Hospital (HBHH) is unique in so many ways. Our facility is located in a serene, picturesque setting within the Spring Branch District of West Houston. We have highly qualified caring staff ready to provide exceptional service.
The team at Houston Behavioral Healthcare Hospital strives to be the leaders in Behavioral Health by delivering quality services to those entrusted in our care. By embarking on a path with our community and ensure Compassion, Acceptance, Respect, Empowerment, and Sincerity with each step we take together.
Houston Behavioral Healthcare Hospital (HBHH) currently has an opening for Fulltime Utilization Management Coordinator.
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to serve as a member of interdisciplinary team supporting the organization's treatment program and philosophy, and assure the deliverance of quality treatment to patients and their families.
Duties:
- Assists with collecting information from patients and families that will help to develop treatment and discharge plans.
- Develops and coordinates an individualized discharge plan for the patient by utilizing treatment team and written chart information to determine the patient's aftercare needs.
- Coordinates with physician individualized discharge planning for patients.
- Conducts reviews and other communications and documentation as required by payor standards to obtain necessary certification to maximize reimbursement.
- Act as the liaison for both internal and external reviewers.
- Helps to complete aftercare appointments that are within seven (7) days of discharge.
- Other duties as assigned
Knowledge, Skills and Abilities:
- Basic understanding of human anatomy, specifically musculoskeletal
- Proficient use of CPT and ICD-10 codes
- Excellent computer skills including Excel, Word, and Internet use
- Excellent organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively.
- Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
Job Types: Fulltime
Schedule: Fulltime
- Monday-Friday
- 8am-4pm
Requirements
Bachelors Degree in social work, Psychology or related field, preferred.
1 year experience in a medical related field and/or prior authorization experience preferred.
Experience in a Psychiatric setting.
Knowledge of healthcare service delivery systems, and third party reimbursement.
Knowledgeable of Managed Care Environment.
Reliable and flexible.
Great customer service and team player.
Benefits
401-K Plan
Medical, Dental and Vision
About Houston Behavioral Healthcare Hospital
Sourced by ZipRecruiter
Industry
Offices of mental health practitioners
Company size
201 - 500 Employees
Headquarters location
Houston, TX, US
Year founded
2014