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Chart Utilization Review Jobs in Wisconsin (NOW HIRING)

Program Supervisor

Germantown, WI ยท On-site

$50K - $80K/yr

Conduct chart reviews and documentation audits to ensure quality and regulatory compliance ... Monitor productivity and service utilization metrics. * Collaborate with leadership regarding ...

WI ยท On-site

$210.60 - $257.40/hr

... utilization management. * Oversee clinical emergencies in clinic: syncope, anaphylaxis, drug ... Conduct a minimum 3% monthly chart review for each supervised APP. * Conduct scheduled 1:1 meetings ...

Logistics and Supply Chain Careers at Dematic Chart your path! Whether you are an engineer ... Develop and implement resource management plans, ensuring optimal allocation and utilization of ...

Project Manager

Wauwatosa, WI ยท On-site

$88K - $125K/yr

Logistics and Supply Chain Careers at Dematic Chart your path! Whether you are an engineer ... Develop and implement resource management plans, ensuring optimal allocation and utilization of ...

Travel Physical Therapist

Mequon, WI ยท On-site

$1.6K - $2.0K/wk

Responsibilities * Review and evaluate physician's referral and patient's medical record to ... Maintain appropriate documentation in the patient chart, and re-evaluate patient progress and ...

Travel Physical Therapist

Mequon, WI ยท On-site

$1.7K - $2.0K/wk

Responsibilities * Review and evaluate physician's referral and patient's medical record to ... Maintain appropriate documentation in the patient chart, and re-evaluate patient progress and ...

Showing results 21-40

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?

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.

What cities in Wisconsin are hiring for Chart Utilization Review jobs? Cities in Wisconsin with the most Chart Utilization Review job openings:
Infographic showing various Chart Utilization Review job openings in Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Finance Director

PRN Home Health & Therapy

Appleton, WI โ€ข On-site

Full-time

Re-posted 19 days ago


Job description

SUMMARY STATEMENT

Supports the mission, vision, and values of the organization.

Responsible for planning, coordinating, managing and directing the financial performance of PRN Home Health & Therapy, including  financial and statistical reporting, cost reporting, accounts payable, billing and accounts receivable management and budget preparation.

RESPONSIBILITIES AND DUTIES

  1. Manages and oversees all daily accounting operations and accounting information systems including payroll, accounts payable, accounts receivable, general ledger, financial reporting, and statistical reporting systems.  Implements financial policies, accounting systems and cost controls.
  2. Ensures financial record systems are maintained in accordance with generally accepted accounting principles and in compliance with local, state, and federal laws and ACHC accreditation standards.
  3. Assists in the preparation of the annual budget.
  4. Oversees and is responsible for the management of all accounting information systems
  5. Oversees and ensures maximum third-party reimbursement through efficient billing and collections operations, effective accounts receivable management including working with 3rd party billing companies and insurance companies. .
  6. Protects the assets of the organization through effective internal controls, and direct supervision of financial operations.
  7. Manages and controls cash disbursements through an effective accounts payable system.
  8. Review of financial statements prepared by outside 3rd party includes doing an analysis of financial trends.
  9. Prepares and reports key statistics through the effective utilization of
    information systems.
  10. Provides leadership in strategic financial planning including identifying opportunities for improved fiscal viability
  11. Responsible for the preparation of the annual Medicare cost report and serves as the organization liaison to the Medicare fiscal intermediary.
  12. Acts as the financial liaison to the Governing Body and attends meetings as requested by the Administrator.

DUTIES:

 

  1. Oversees payroll practices and collaborates with other members of the management team in establishing personnel policies that assures compliance with state and federal regulations, including wages, salaries and benefit regulations
  2. Evaluates financial provisions of proposed contracts and agreements for provision of services to optimize financial viability of the agreements.
  3. Stays informed about changes reimbursement, laws, and financial requirements, and shares information with appropriate organization personnel.
  4. Oversees Finance Department. Participates in hiring, onboarding, disciplining and training of finance personnel. Conducts performance reviews for financial team. 
  5. Document communication with patients, financial representatives, payors, etc. appropriately in patient chart related to payments.
  6. Attend and participate in leadership meetings, staff meetings, or other meetings as required.
  7. Act in compliance with PRN Home Health and Therapy Management policies and procedures, State, Federal and Professional Organization regulatory and professional standards and guidelines.
  8. Participate in quality improvement processes as directed by the organization.
  9. Complete all documentation, payroll, billing, and required reporting accurately and in a timely manner.
  10. Maintains patient and organization confidentiality at all times
  11. Perform other duties as assigned.

Position REQUIREMENTS

  1. Minimum of Bachelor’s Degree in Accounting (preferred), Finance, or Business Management, related field or equivalent experience.
  2. Excellent verbal and written communication skills
  3. An ability to work individually or in a team environment; Self-directing with the ability to work with little direct supervision
  4. Good judgement and discretion when dealing with sensitive topics
  5. Able to interact with many people and multiple interruptions while staying on task
  6. Extensive knowledge and experience in Microsoft Office programs, including Excel and Word
  7. Demonstrates tact, patience and good personal hygiene
  8. Excellent oral and written communication skills
  9. Able to supervise others in a team-oriented environment
  10. Extremely high attention to detail and accuracy
  11. Prefer prior experience working in healthcare operations and with insurance reimbursement
  12. Prefer prior experience working with Sage

PHYSICAL DEMANDS & WORK ENVIRONMENT

  1. Able to work in office environment which may include sitting. standing at desk for extended time frames