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Chart Utilization Review Jobs (NOW HIRING)

ICONMA

Clinical Utilization Review Nurse II

Worker will need to have their own equipment to conduct chart reviews. Will need experience in Cerner with understanding of MCG and utilization review requirements for concurrent and initial reviews.

New

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 ...

She Recruits LLC

Gastroenterology - Chart Review

Join us as an Medical Director to conduct chart and peer reviews from your home office. Where you ... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ...

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How much do chart utilization review jobs pay per hour?

As of Aug 7, 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 August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Coordinator

Pyramid Healthcare

Allentown, PA

$20/hr

Full-time

Posted 9 days ago

Pyramid Healthcare rating

4.8

Company rating: 4.8 out of 10

Based on 58 frontline employees who took The Breakroom Quiz

869th of 887 rated healthcare providers

Job description

Deliverables/Principal Results Expected:
Perform admission, continued stay and discharge reviews on all managed care clients.
Maintain positive relationships with referral sources and insurance companies.
Track admissions, continued stay and discharge ASAM requirements for county referrals.
Maintain organized system of reporting to counselors when ASAM's are due and when review calls are to be made.
Maintain current insurance eligibility information through EVS, Navinet, etc.
Monitor Census for accuracy of funding.
Attend clinical staffing to obtain information for client reviews.
Maintain daily UR database accurately.
Perform Act 106 reviews and follow up appeals.
Track all county referrals for documentation of admission calls.
Maintain and participate in chart reviews to ensure proper paperwork is in place.
Work directly with Billing Department to reduce uncovered days of funding. Investigate cases with insurance and referral sources to recuperate lost days of funding.
Report to the Assessment Manager on a weekly basis.
Manage all self-pay clients and clients with copays, deductibles, coinsurance and liabilities.
Reduce client balances.
Other duties as assigned.


Technical Competencies:
Provide the company with accurate information to ensure full financial coverage for each client day. Provide the referral source(s) with timely information to ensure good customer focus. Maintain client confidentiality and provide a safe therapeutic treatment. Knowledge of local, state and federal regulations. Knowledge of facility contracts and agreements. Knowledge of medical terminology, appeal and denial process, composition of medical records. Knowledge of data entry (primarily Excel) and mathematics. Knowledge of pre-certification process and ASAM. Knowledge of CARF standards, release of information and confidentiality. Knowledge of DSM V, private care managers and county referral sources.


Education, Experience:
Associate Degree or equivalent required; Bachelor of Science in Behavioral Health. Intermediate knowledge of computer skills and the internet, Microsoft Office experience, Excel- Intermediate level, Word- Intermediate level. 3-5 years' experience in Utilization Review or related position in a healthcare setting.


Job-related Behavioral Characteristics:
Demonstrates professionalism, leadership, confidentiality, strong social communication skills, time-management, organized. Must possess skills to communicate effectively and interact well with people of diverse backgrounds. Excellent oral and written communication and interpersonal skills. Ability to problem solve by gathering and analyzing information, working well in an individual/ group problem solving situation, and showing initiative in problem solving. Maintains professionalism and does not show favoritism. Maintains consistency with clients, staff, visitors, and the public. Ability to handle a crisis situation and react appropriately. Flexibility and adaptable. Ability to make decisions in an objective and ethical manner. Calm and decisive in crisis situations. Ability to sustain a team environment, drive continuous improvement projects, confidentiality, excellent problem-solving skills and excellent communicator within the team framework. Self-starter, takes initiative.

The starting compensation for this role is $20/hour; final compensation will be determined based on skills, experience, and qualifications.

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