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 ...
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 ...
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
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 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 ...
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 ...
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 ...
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 Director Department: Medical Operations Employment Qualifications: * Must hold a valid nursing ...
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 ...
... 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 ...
Owens Cross Roads, AL · On-site
The Master Level Therapist acts as a liaison with sponsoring agencies, including utilization review ... Medical, dental, vision, and life insurance after 60 days * Company provided Short Term and ...
Owens Cross Roads, AL · On-site
The Master Level Therapist acts as a liaison with sponsoring agencies, including utilization review ... Medical, dental, vision, and life insurance after 60 days * Company provided Short Term and ...
$19.39 - $23.31
2% of jobs
$23.31 - $27.24
9% of jobs
$29.92 is the 25th percentile. Wages below this are outliers.
$27.24 - $31.16
21% of jobs
The median wage is $34.33 / hr.
$31.16 - $35.08
23% of jobs
$35.08 - $39
13% of jobs
$42.05 is the 75th percentile. Wages above this are outliers.
$39 - $42.92
10% of jobs
$42.92 - $46.84
8% of jobs
$46.84 - $50.77
5% of jobs
$50.77 - $54.69
5% of jobs
$54.69 - $58.61
2% of jobs
$58.61 - $62.53
2% of jobs
$19
$38
$62
An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.
To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.
One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.
The most popular types of Insurance Utilization Review jobs in Alabama are:
For Insurance Utilization Review jobs in Alabama, the most frequently searched job titles are:
The top searched job categories for Insurance Utilization Review jobs in Alabama are:
Cities in Alabama with the most Insurance Utilization Review job openings:
Gadsden, AL • On-site
6.4
Based on 286 frontline employees who took The Breakroom Quiz
645th of 895 rated healthcare providers
Free food
People enjoy working here
Recommended by students
Recommended by parents
Respectful managers
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 16 days ago
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
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