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 ...
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 ...
Utilization Review Technician
Gadsden, AL · On-site
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 ...
Utilization Review Technician
Gadsden, AL · On-site
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 ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking a n Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking a n Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
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 ...
Utilization Review Technician
Gadsden, AL · On-site
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 ...
Utilization Review Technician
Gadsden, AL · On-site
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 ...
Utilization Review Technician
Gadsden, AL · On-site
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 ...
RN Utilization Review
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL licensure as RN or LPN Knowledge, Skills, and Abilities * Knowledge of third-party payer ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL licensure as RN or LPN Knowledge, Skills, and Abilities * Knowledge of third-party payer ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL licensure as RN or LPN Knowledge, Skills, and Abilities * Knowledge of third-party payer ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL licensure as RN or LPN Knowledge, Skills, and Abilities * Knowledge of third-party payer ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
New
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
New
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
RN Utilization Review-Crestwood Medical Center-Case Management-FT-1st shift
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Hourly Weekend Utilization Review information
What is the difference between Hourly Weekend Utilization Review vs Medical Billing Specialist?
| Aspect | Hourly Weekend Utilization Review | Medical Billing Specialist |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications, such as RHIT or RHIA | Requires coding certifications like CPC or CCS |
| Work Environment | Healthcare facilities, insurance companies, or utilization review organizations, often during weekends | Medical offices, billing companies, or hospitals, primarily weekdays |
| Job Focus | Assessing patient care and resource utilization during weekends | Processing insurance claims, coding, and billing |
Hourly Weekend Utilization Review involves evaluating patient care and resource use during weekends, often requiring healthcare certifications. In contrast, Medical Billing Specialists focus on coding and billing processes, mainly during weekdays. Both roles are essential in healthcare operations but differ in focus, credentials, and work hours.
Utilization Review Technician
Gadsden, AL
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 16 days ago
Job description
Department:Â Social Work ServicesÂ
Shifts Available: Days Â
Employment Type:Â Full TimeÂ
Hours: 8-hour shift - 7:30am to 3:30pmÂ
Location: Riverview Regional Medical Center - Gadsden, ALÂ
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.Â
Responsibilities- Coordinate phone calls, data entry, and tracking related to authorizations, expedited reviews, appeals, and denialsÂ
- Document and track all communication attempts with insurance providers and health plansÂ
- Follow up on denials while partnering with Utilization Review, Business Office, and Case Management teamsÂ
- Maintain accurate tracking of government and payer audits, including RAC, MAC, CERT, ADR, QIO, Medicaid, and pre/post-payment reviewsÂ
- Provide support with Release of Information, discharge coordination, and other assigned departmental dutiesÂ
- High School Diploma or equivalent
- Two years of relevant experience
- Accurate alphabetic, numeric, and/or terminal-digit filing skills
- Computer data entry with 10-key, with accurate typing speed of 35 wpm
- Associates Degree or higher, preferred
- Excel skills. highly preferred
- Knowledge of terminal digit filing and medical terminology, preferred
- Knowledge of State and Federal regulatory requirements for medical staff documentation, preferred
- Completion of a medical terminology course, preferred
- Background in business and office training, preferred
Here are some of the benefits of working at Prime Healthcare:Â
- Health, dental, and vision insurance optionsÂ
- Paid vacation, sick time and holidaysÂ
- Bereavement leave, FMLA and other leave optionsÂ
- Employer 401K optionsÂ
- Tuition reimbursement options Â
- Life, disability, and other insurance optionsÂ
- Many other amazing benefitsÂ
Full benefits at Prime Healthcare:Â https://www.primehealthcare.com/careers/benefits/Â Â Â
#LI-MP1
Employment StatusFull TimeShiftDaysEqual Employment OpportunityCompany 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:Â https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
 Employment Type: FULL_TIME