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
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 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 ...
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 ...
| Aspect | Insurance Utilization Reviewer | Insurance Claims Processor |
|---|---|---|
| Primary Role | Review medical necessity and appropriateness of services for insurance coverage | Process and review insurance claims for payment and accuracy |
| Required Credentials | Often requires healthcare or insurance certifications, such as RHIT or CPC | Typically requires claims processing or insurance certifications, like CPC or CPC-H |
| Work Environment | Healthcare settings, insurance companies, or third-party administrators | Insurance companies, healthcare providers, or claims processing centers |
| Industry Usage | Commonly employed in health insurance and managed care | Widely used across health, auto, and property insurance sectors |
The main difference is that Insurance Utilization Reviewers focus on evaluating the medical necessity of services, while Insurance Claims Processors handle the administrative processing of claims. Both roles require insurance-related certifications and are integral to the insurance industry, but they serve distinct functions in the claims and coverage review process.
For Insurance Utilization Reviewer jobs in Alabama, the most frequently searched job titles are:
The top searched job categories for Insurance Utilization Reviewer jobs in Alabama are:
Cities in Alabama with the most Insurance Utilization Reviewer job openings:
Gadsden, AL • On-site
6.4
Based on 286 frontline employees who took The Breakroom Quiz
647th of 896 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 19 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/
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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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