Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Complete insurance verification from various payors and obtain correct information to complete ... Minimum of two years psychiatric experience in chart analysis and in the utilization review field.
Interface with external agencies/representatives relative to the utilization review process including, but not limited to, Third-Party Payers, Insurance Companies and Providers. Perform Utilization ...
Interface with external agencies/representatives relative to the utilization review process including, but not limited to, Third-Party Payers, Insurance Companies and Providers. Perform Utilization ...
Interface with external agencies/representatives relative to the utilization review process including, but not limited to, Third-Party Payers, Insurance Companies and Providers. Perform Utilization ...
Interface with external agencies/representatives relative to the utilization review process including, but not limited to, Third-Party Payers, Insurance Companies and Providers. Perform Utilization ...
Telephonic Case Manager (RN)
Columbia, SC · On-site
... utilization review process including, but not limited to, Third-Party Payers, Insurance Companies and Providers. • Perform Utilization Review activities prospectively, concurrently or ...
Telephonic Case Manager (RN)
Columbia, SC · On-site
... utilization review process including, but not limited to, Third-Party Payers, Insurance Companies and Providers. • Perform Utilization Review activities prospectively, concurrently or ...
Medical Director
Columbia, SC · On-site +1
$225K - $428K/yr
... Health Insurance Marketplace. Looking for a compelling opportunity to move beyond patient ... Performs medical review activities pertaining to utilization review, quality assurance, and medical ...
Medical Director
Columbia, SC · On-site +1
$225K - $428K/yr
... Health Insurance Marketplace. Looking for a compelling opportunity to move beyond patient ... Performs medical review activities pertaining to utilization review, quality assurance, and medical ...
Medical Director
Columbia, SC · On-site +1
$225K - $428K/yr
... Health Insurance Marketplace. Looking for a compelling opportunity to move beyond patient ... Performs medical review activities pertaining to utilization review, quality assurance, and medical ...
Medical Director
Columbia, SC · On-site +1
$225K - $428K/yr
... Health Insurance Marketplace. Looking for a compelling opportunity to move beyond patient ... Performs medical review activities pertaining to utilization review, quality assurance, and medical ...
We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for performing utilization management reviews of prior authorization request for ...
We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for performing utilization management reviews of prior authorization request for ...
We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for performing utilization management reviews of prior authorization request for ...
We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for performing utilization management reviews of prior authorization request for ...
Physician Reviewer-Radiology (Part Time)
Columbia, SC · On-site
$95 - $100/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...
Physician Reviewer-Radiology (Part Time)
Columbia, SC · On-site
$95 - $100/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...
We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for performing utilization management reviews of prior authorization request for ...
We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for performing utilization management reviews of prior authorization request for ...
UTILIZATION AND COST MANAGEMENT The BH Physician Reviewer ensures defensible, evidence based ... Life Insurance * Paid Time Off (PTO) * On-site cafeterias and fitness centers in major locations
UTILIZATION AND COST MANAGEMENT The BH Physician Reviewer ensures defensible, evidence based ... Life Insurance * Paid Time Off (PTO) * On-site cafeterias and fitness centers in major locations
Insurance Utilization Review information
See Columbia, SC salary details
$18.50 - $22.24
2% of jobs
$22.24 - $25.98
9% of jobs
$28.54 is the 25th percentile. Wages below this are outliers.
$25.98 - $29.72
21% of jobs
The median wage is $32.75 / hr.
$29.72 - $33.46
23% of jobs
$33.46 - $37.20
13% of jobs
$40.11 is the 75th percentile. Wages above this are outliers.
$37.20 - $40.94
10% of jobs
$40.94 - $44.68
8% of jobs
$44.68 - $48.43
5% of jobs
$48.43 - $52.17
5% of jobs
$52.17 - $55.91
2% of jobs
$55.91 - $59.65
2% of jobs
$18
$36
$59
How much do insurance utilization review jobs pay per hour?
What are the most common challenges faced by insurance utilization review professionals?
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.
What are the key skills and qualifications needed to thrive in insurance utilization review?
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.
What is an insurance utilization review?
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.
- Online Utilization Review
- Remote Occupational Therapy Utilization Review
- Utilization Review
- Utilization Review Coordinator
- Remote Aetna Utilization Review Nurse
- Senior Rn Utilization Review Nurse
- Remote Insurance Utilization Review
- Weekend Utilization Review
- Registered Nurse Case Review
- Temporary Aetna Utilization Review Nurse

Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 19 days ago
Universal Health Services rating
6.8
Based on 253 frontline employees who took The Breakroom Quiz
490th of 887 rated healthcare providers
Job description
Three Rivers Behavioral Health is a 136-bed treatment facility that specializes in quality behavioral health and substance abuse services for adolescents and adults. We offer a full continuum of care through an integrated system of inpatient, partial hospitalization and intensive outpatient programs. Conveniently located between I-20 (Exit 61) and I-26 (Exit 110) in West Columbia, SC, our team of 300+ high quality employees describe working here as " family atmosphere," "supportive leadership," and "life-changing." Progressive professionals in the fields of psychiatry, medicine, nursing, social services, and activity therapy serve hundreds of adults and adolescents each month with the common goal of creating new beginnings. Healthcare professionals have a unique opportunity to affect lives for the better each and every day. Choose Three Rivers and start your life-changing journey today.
Job Duties/Responsibilities:
- This position provides precertification and verification of benefits for incoming patients.
- Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations/managed care companies.
- Discuss with patient various forms and obtain signatures from the patients.
- Complete insurance verification from various payors and obtain correct information to complete precertification as well as appeals.
BENEFITS:
Career development opportunities across UHS and our 300+ locations!
Diverse programming to expand your experience
Competitive Compensation & Generous Paid Time Off
Excellent Medical, Dental, Vision and Prescription Drug Plans
Employee Assistance Program
401(K) with company match and discounted stock plan
Pet Insurance
SoFi Student Loan Refinancing Program
Tuition Assistance
Employee Referral Program
More information is available on our Benefits Guest Website: benefits.uhsguest.com
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World’s Most Admired Companies by Fortune; listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications
Job Requirements:
- Education: Masters’ degree in a recognized mental health field or Registered Nurse.
- Experience:
- Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written communication skills required in order to communicate in a clear and concise manner with patients, physicians, staff and payors.
- Knowledge of external review organizations, payor sources, financial planning and contracting (i.e., managed care, Medicare, Medicaid, etc.)
- Must be able to work in a fast-paced environment with frequent interruptions.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS
and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Qualifications:Job Requirements:
- Education: Masters’ degree in a recognized mental health field or Registered Nurse.
- Experience:
- Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written communication skills required in order to communicate in a clear and concise manner with patients, physicians, staff and payors.
- Knowledge of external review organizations, payor sources, financial planning and contracting (i.e., managed care, Medicare, Medicaid, etc.)
- Must be able to work in a fast-paced environment with frequent interruptions.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS
and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Education:UNAVAILABLEEmployment Type: FULL_TIMEWhat Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
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About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US