Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and ... Utilization Review experience preferred. * Expected to work under minimal management supervision
Birmingham, AL · On-site
$115K - $130K/yr
Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more ... This leader provides direct oversight of Utilization Review Managers and Utilization Review ...
Birmingham, AL · On-site
$115K - $130K/yr
Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more ... This leader provides direct oversight of Utilization Review Managers and Utilization Review ...
Birmingham, AL · On-site
$115K - $130K/yr
Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more ... This leader provides direct oversight of Utilization Review Managers and Utilization Review ...
Birmingham, AL · On-site
$115K - $130K/yr
Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more ... This leader provides direct oversight of Utilization Review Managers and Utilization Review ...
Insurance Verification and Resource Utilization Nurse Immediate Supervisor: Clinical Coordinator Manager Director Department: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
New
Insurance Verification and Resource Utilization Nurse Immediate Supervisor: Clinical Coordinator Manager Director Department: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
New
Insurance Verification and Resource Utilization Nurse Immediate Supervisor: Clinical Coordinator Manager Director Department: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
New
Insurance Verification and Resource Utilization Nurse Immediate Supervisor: Clinical Coordinator Manager Director Department: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
New
Birmingham, AL · On-site
Insurance Verification and Resource Utilization Nurse Immediate Supervisor: Clinical Coordinator Manager Director Department: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
Birmingham, AL · On-site
Insurance Verification and Resource Utilization Nurse Immediate Supervisor: Clinical Coordinator Manager Director Department: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
Insurance Verification and Resource Utilization Nurse Immediate Supervisor: Clinical Coordinator Manager DirectorDepartment: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
Insurance Verification and Resource Utilization Nurse Immediate Supervisor: Clinical Coordinator Manager DirectorDepartment: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
... private business and government utilization review, medical review, cost containment ... the health insurance program administered by this corporation. The incumbent must be able to ...
... private business and government utilization review, medical review, cost containment ... the health insurance program administered by this corporation. The incumbent must be able to ...
Birmingham, AL · On-site
... private business and government utilization review, medical review, cost containment ... the health insurance program administered by this corporation. The incumbent must be able to ...
Birmingham, AL · On-site
... private business and government utilization review, medical review, cost containment ... the health insurance program administered by this corporation. The incumbent must be able to ...
| Aspect | Contractual Insurance Utilization Review | Insurance Claims Adjuster |
|---|---|---|
| Credentials | Certifications in healthcare or insurance review, such as URAC or AAPC | Adjuster licenses, certifications like AIC or CPCU |
| Work Environment | Healthcare facilities, insurance companies, or third-party review organizations | Insurance companies, claims offices, or independent agencies |
| Primary Focus | Assessing medical necessity and appropriateness of services | Evaluating insurance claims for coverage and settlement |
| Industry Usage | Common in health insurance and managed care | Common in property, casualty, and health insurance claims |
Contractual Insurance Utilization Review focuses on evaluating medical necessity, while Insurance Claims Adjusters handle claims processing and settlement. Both roles require industry-specific certifications and are integral to insurance operations, but they serve different functions within the insurance process.
The most popular types of Insurance Utilization Review jobs in Alabama are:
Cities in Alabama with the most Contractual Insurance Utilization Review job openings:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 9 days ago
6.5
Based on 285 frontline employees who took The Breakroom Quiz
607th of 891 rated healthcare providers
Department: Social Work Services
Shifts Available: Days
Employment Type: Full Time
Hours: 8-hour shift – 7:30am to 3:30pm
Location: Riverview Regional Medical Center – Gadsden, AL
We are seeking an Utilization Review Technician II, sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator II. The Utilization Review Technician II supports the utilization review, appeals, and denial management process by coordinating communication and tracking payer-related activity. This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals, and denials. The position also assists with payer audits, Release of Information, discharge coordination, and other departmental needs.
Here are some of the benefits of working at Prime Healthcare:
Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/
#LI-MP1
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
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Hospitals
10,000+ Employees
Ontario, CA, US
