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Concurrent Review Jobs in Georgia (NOW HIRING)

St. Joseph's/Candler

Office Coordinator

Savannah, GA

$16.09/hr

Perform initial review prior to date of service and concurrent review until precertification obtained. Communicate and collaborate with other departments to eliminate precertification denials.

St. Joseph's/Candler

Office Coordinator

Savannah, GA

$16.09/hr

Perform initial review prior to date of service and concurrent review until precertification obtained. Communicate and collaborate with other departments to eliminate precertification denials.

St. Joseph's/Candler

Office Coordinator

Savannah, GA · On-site

$16.09/hr

Perform initial review prior to date of service and concurrent review until precertification obtained. Communicate and collaborate with other departments to eliminate precertification denials.

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from ...

Monogram Health

Market Physician Executive

Savannah, GA · Remote

Actively lead daily high-risk and concurrent review rounds, and direct supervision of front-line clinical and operations team members. * Provide direct and indirect patient care (including diagnosis ...

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Concurrent Review information

What are the key skills and qualifications needed to thrive as a Concurrent Review Nurse, and why are they important?

To thrive as a Concurrent Review Nurse, you need a strong clinical background, current RN licensure, and a thorough understanding of utilization management and healthcare regulations. Familiarity with case management software, electronic health records (EHRs), and knowledge of insurance guidelines and ICD/CPT coding is typically required. Excellent analytical thinking, communication skills, and attention to detail help in collaborating with providers and ensuring appropriate care. These competencies are crucial for ensuring patients receive medically necessary care while maintaining compliance and cost-effectiveness.

What is a concurrent review?

A concurrent review is a process used in healthcare and insurance jobs where a professional evaluates a patient's case or claim while treatment or services are ongoing. This review helps determine the appropriateness, necessity, and efficiency of care in real-time, often requiring knowledge of medical records and insurance policies. It is commonly performed by healthcare professionals, case managers, or claims reviewers to ensure quality and compliance.

What is an example of a concurrent review?

A concurrent review is a process used by healthcare professionals, including those in roles like Concurrent Review, to evaluate a patient's treatment and progress while they are still receiving care. For example, reviewing a patient's hospital stay daily to determine if continued hospitalization is necessary or if care can be transitioned to outpatient services. This process helps ensure appropriate utilization of resources and timely care adjustments.

What is concurrent review in healthcare?

Concurrent review is a process used in healthcare to assess the necessity and appropriateness of ongoing inpatient care while the patient is still hospitalized. The goal is to ensure that medical services are being delivered efficiently and according to established guidelines. Utilization review nurses or case managers typically conduct these reviews by evaluating medical records, communicating with providers, and making recommendations regarding continued stay or discharge planning. This helps control healthcare costs and improves patient outcomes by preventing unnecessary treatments or extended hospitalizations.

How to make an extra 2000 a month as a nurse?

Concurrent Review nurses can increase their income by taking on overtime shifts, working in high-demand specialties, or pursuing certifications that qualify them for higher-paying roles. Additionally, some may supplement income through per diem work, telehealth services, or consulting opportunities within their field.

What is the difference between Concurrent Review vs Utilization Review?

AspectConcurrent ReviewUtilization Review
PurposeAssess ongoing patient care during hospitalizationEvaluate the necessity and appropriateness of services, often before or after care
TimingPerformed in real-time during treatmentCan be pre-authorization, concurrent, or retrospective
Work EnvironmentHospitals, clinics, insurance companiesInsurance companies, healthcare organizations
CredentialsRegistered nurses, case managers, healthcare professionalsMedical reviewers, nurses, case managers

Concurrent Review focuses on evaluating ongoing patient care during hospitalization, ensuring treatments are appropriate in real-time. Utilization Review has a broader scope, including pre-authorization and retrospective assessments to determine the necessity of services. While both roles involve healthcare professionals and are used within insurance and healthcare settings, their timing and specific focus differ.

What are some common challenges faced by Concurrent Review nurses, and how can they be managed?

Concurrent Review nurses often face challenges such as managing a high volume of case reviews within tight deadlines and ensuring timely communication with providers and insurance companies. Staying organized, utilizing efficient documentation systems, and maintaining up-to-date knowledge of regulatory requirements can help overcome these hurdles. Collaboration with interdisciplinary teams and regular training on evolving guidelines are also essential for success in this role.

How to make 300,000 as a nurse?

To earn $300,000 as a nurse, professionals typically work in high-paying specialties such as nurse anesthetist, nurse practitioner, or clinical nurse specialist, often requiring advanced certifications and a master's or doctoral degree. Gaining experience, working overtime, and seeking employment in high-demand settings or geographic areas with higher pay can also increase earnings.
What are popular job titles related to Concurrent Review jobs in Georgia? For Concurrent Review jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Concurrent Review jobs in Georgia look for? The top searched job categories for Concurrent Review jobs in Georgia are:
Concurrent Review jobs near you
Infographic showing various Concurrent Review job openings in Georgia as of July 2026, with employment types broken down into 1% Locum Tenens, 1% As Needed, 87% Full Time, 7% Part Time, 1% Temporary, and 3% Contract. Highlights an 84% Physical, 5% Hybrid, and 11% Remote job distribution.
Precertification Specialist Assistant

Precertification Specialist Assistant

St. Joseph's/Candler

Savannah, GA • On-site

$16.09/hr

Full-time

Posted 14 days ago

St. Joseph's/Candler Health System rating

6.3

Company rating: 6.3 out of 10

Based on 18 frontline employees who took The Breakroom Quiz

Job description

  • Position Summary
    • The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service and maintain a working knowledge of industry standards to ensure timely, quality services in accordance with contractual agreements, federal regulations, hospital policies, procedures and professional standards.
  • Education
    • High School Diploma - Preferred
  • Experience
    • 2-3 Years Clerical - Required
    • 1-2 Years Insurance  - Preferred
  • License & Certification
    • None Required
  • Core Job Functions
    • Compile and distribute daily service report. Review account to determine if certification is required. Work with physician offices and other hospital departments to make sure required certification is obtained and documented.
    • Determines if authorization is required. Accurately documents account information.
    • Monitor various reports for precertification need. Perform initial review prior to date of service and concurrent review until precertification obtained. Communicate and collaborate with other departments to eliminate precertification denials.
    • Review updated information from payers, Monitor web portal alerts from payer. Maintains updated files on specific payer requirements.

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