Utilization Review Assistant
Odessa, TX · On-site
Familiar with medical terminology, utilization review, and/or medical insurance preferred. Ability to communicate effectively and professionally, both verbally and in writing.
Odessa, TX · On-site
Familiar with medical terminology, utilization review, and/or medical insurance preferred. Ability to communicate effectively and professionally, both verbally and in writing.
Odessa, TX · On-site
Familiar with medical terminology, utilization review, and/or medical insurance preferred. Ability to communicate effectively and professionally, both verbally and in writing.
Familiar with medical terminology, utilization review, and/or medical insurance preferred. Ability to communicate effectively and professionally, both verbally and in writing.
Familiar with medical terminology, utilization review, and/or medical insurance preferred. Ability to communicate effectively and professionally, both verbally and in writing.
The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... insurance information, provide clinical updates to 3rd Party payors, place accounts on hold and ...
The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... insurance information, provide clinical updates to 3rd Party payors, place accounts on hold and ...
Midland, TX · On-site
The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... Communicates and works closely with insurance companies to ensure that the organization will be ...
Midland, TX · On-site
The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... Communicates and works closely with insurance companies to ensure that the organization will be ...
Dallas, TX · On-site
$90K - $98K/yr
As a Utilization Review Nurse (UR Nurse) , you'll play an important role in helping us offer customized, self-funded insurance options to our clients and members. The UR Nurse is responsible for ...
New
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Dallas, TX · On-site
$90K - $98K/yr
As a Utilization Review Nurse (UR Nurse) , you'll play an important role in helping us offer customized, self-funded insurance options to our clients and members. The UR Nurse is responsible for ...
New
Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...
Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...
Verify insurance benefits and eligibility prior to client admission * Coordinate and manage ... Respond promptly to emails, phone calls, and requests related to utilization review * Support ...
Verify insurance benefits and eligibility prior to client admission * Coordinate and manage ... Respond promptly to emails, phone calls, and requests related to utilization review * Support ...
Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...
Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...
Verify insurance benefits and eligibility prior to client admission * Coordinate and manage ... Respond promptly to emails, phone calls, and requests related to utilization review * Support ...
Verify insurance benefits and eligibility prior to client admission * Coordinate and manage ... Respond promptly to emails, phone calls, and requests related to utilization review * Support ...
Verify insurance benefits and eligibility prior to client admission * Coordinate and manage ... Respond promptly to emails, phone calls, and requests related to utilization review * Support ...
Verify insurance benefits and eligibility prior to client admission * Coordinate and manage ... Respond promptly to emails, phone calls, and requests related to utilization review * Support ...
Plano, TX · Remote
... insurance or managed care industry using medically accepted criteria to validate the medical ... This position is responsible for performing initial, concurrent review activities; discharge care ...
Plano, TX · Remote
... insurance or managed care industry using medically accepted criteria to validate the medical ... This position is responsible for performing initial, concurrent review activities; discharge care ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
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This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...
Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
Registered Nurse, Utilization Review (Remote) Local Candidates in the Austin, TX Area Only ... Life and disability insurance * Additional voluntary benefits Join MMC and enjoy the support of a ...
Registered Nurse, Utilization Review (Remote) Local Candidates in the Austin, TX Area Only ... Life and disability insurance * Additional voluntary benefits Join MMC and enjoy the support of a ...
Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...
Recent work experience in a hospital or insurance company providing utilization review services * Knowledge of Medicare, Medicaid, and Managed Care requirements * Progressive knowledge of community ...
Registered Nurse, Utilization Review (Remote) Local Candidates in the Austin, TX Area Only ... Life and disability insurance * Additional voluntary benefits Join MMC and enjoy the support of a ...
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Registered Nurse, Utilization Review (Remote) Local Candidates in the Austin, TX Area Only ... Life and disability insurance * Additional voluntary benefits Join MMC and enjoy the support of a ...
Houston, TX · On-site
... Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect ... utilization review activities accurately and timely within the electronic health record (EHR). o ...
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Houston, TX · On-site
... Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect ... utilization review activities accurately and timely within the electronic health record (EHR). o ...
To monitor adherence to the hospital's utilization review plan to ensure the effective and ... Knowledge of various insurance plan coverages for Home Health, DME, SNF, LTAC agencies. * Works ...
To monitor adherence to the hospital's utilization review plan to ensure the effective and ... Knowledge of various insurance plan coverages for Home Health, DME, SNF, LTAC agencies. * Works ...
$19.93 - $23.96
2% of jobs
$23.96 - $27.99
9% of jobs
$30.75 is the 25th percentile. Wages below this are outliers.
$27.99 - $32.03
21% of jobs
The median wage is $35.29 / hr.
$32.03 - $36.06
23% of jobs
$36.06 - $40.09
13% of jobs
$43.22 is the 75th percentile. Wages above this are outliers.
$40.09 - $44.12
10% of jobs
$44.12 - $48.15
8% of jobs
$48.15 - $52.18
5% of jobs
$52.18 - $56.21
5% of jobs
$56.21 - $60.24
2% of jobs
$60.24 - $64.28
2% of jobs
$19
$39
$64
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.
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.
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.

Assist the UM Department with utilization review processes.
Collect and analyze various computer-based data related to Utilization Review, Care Coordination, and Commercial Insurance.
8.2
Based on 30 frontline employees who took The Breakroom Quiz
53rd of 877 rated healthcare providers
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Health care and social assistance
1,001 - 5,000 Employees
Odessa, TX, US
1949