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Concurrent Review Jobs in Georgia (NOW HIRING)

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 ...

Phoebe Putney Health System

Patient Account Rep.

Albany, GA · On-site

$16.50 - $21.75/hr

Coordinates with concurrent review precert nurse and/or admitting staff on precertification requirements. Prepares daily productivity reports. CUSTOMER SERVICE - PATIENT CLAIM ISSUES: Serves as ...

Monogram Health

Market Physician Executive

Atlanta, GA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Review and approve APP, RN, SW, and PharmD plans of care. * Provide direct and indirect patient care, including diagnosis and treatment of disease. * Engage with patients on treatment plans ...

Phoebe Putney Health System

Patient Account Rep.

Albany, GA · On-site

$16.50 - $21.75/hr

Coordinates with concurrent review precert nurse and/or admitting staff on precertification requirements. Prepares daily productivity reports. CUSTOMER SERVICE - PATIENT CLAIM ISSUES: Serves as ...

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Showing results 21-40

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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 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.

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.

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 August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Team Leader, Office Coordinator

St. Joseph's/Candler

Savannah, GA • On-site

$18.15/hr

Full-time

Posted 11 days ago

St. Joseph's/Candler Health System rating

7.0

Company rating: 7.0 out of 10

Based on 20 frontline employees who took The Breakroom Quiz

Job description

  • Position Summary
    • The Office Coordinator Team Lead serves to facilitate communications among office coordinators, assist in training and trouble shooting issues. Functions as a super user learning new processes and training the team. The predominant responsibility is to work alongside team as office coordinator who provides administrative support to clinical staff. Answers telephone, screens calls, routes appropriately, retrieves and relays messages. Verifies patient information for registration and insurance verification. Coordinates patient scheduling internally & externally. Obtains precertifications, or assists in the precertification  process, as required by healthcare insurers and/or managed care. Scans & enters documentation to EMR to substantiate patient treatment & claim submission. Participates in unit activities to promote patient satisfaction and performance improvement.
  • Education
    • Associates of Healthcare - Preferred
  • Experience
    • 3-5 Years General Medical Office - Required
  • License & Certification
    • None Required
  • Core Job Functions
    • Verification of patient demographics, insurance and other vital statistical information required to identify and submit insurance claims for services rendered. Collect information required by government and the health system for analysis as necessary. Scan required documentation to support necessary insurance and healthcare claim processing.
    • Coordinate various forms of communications to ensure messages and correspondences are delivered to the appropriate person. Respond timely to inquiries according to protocol. Prioritize messages and follow up to assure response to urgent messages has occurred.
    • 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.
    • Assures fiscal compliance related to patient billing and coding. Correctly bill patients for services and accurately document to support charges.
    • Perform patient and provider scheduling activities according to SOPs to include but not be limited to clinic visits, referral visits, diagnostic and other treatment visits. Maintain clinical schedule to assure appropriate patient flow per medical staff's expectations and guidelines. Review daily authorization status with insurance representative for all patients coming to the service.

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