Position Summary In this role, you will coordinate and manage insurance utilization review activities for hospitalized clients. You'll work closely with clinical teams, insurance representatives, and ...
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Position Summary In this role, you will coordinate and manage insurance utilization review activities for hospitalized clients. You'll work closely with clinical teams, insurance representatives, and ...
Quick apply
Position Summary In this role, you will coordinate and manage insurance utilization review activities for hospitalized clients. You'll work closely with clinical teams, insurance representatives, and ...
Tampa, FL · On-site
$59K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Tampa, FL · On-site
$59K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Tampa, FL · On-site
$59K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Tampa, FL · On-site
$59K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
... insurance company reimbursement policies. Performs utilization review and management, including ... quality review, case review for third party payers' requirements. Ensures optimal reimbursement ...
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... insurance company reimbursement policies. Performs utilization review and management, including ... quality review, case review for third party payers' requirements. Ensures optimal reimbursement ...
Lucie Hospital is seeking a detail-oriented Utilization Review Coordinator to coordinate insurance reviews, monitor patient authorizations, and support effective communication between the hospital ...
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Lucie Hospital is seeking a detail-oriented Utilization Review Coordinator to coordinate insurance reviews, monitor patient authorizations, and support effective communication between the hospital ...
... insurance companies on concurrently denied and high risk for denial cases * Documentation ... in Utilization Review · Strong understanding of revenue cycle management and healthcare ...
... insurance companies on concurrently denied and high risk for denial cases * Documentation ... in Utilization Review · Strong understanding of revenue cycle management and healthcare ...
Pompano Beach, FL · Remote
$45K - $65K/hr
Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...
Pompano Beach, FL · Remote
$45K - $65K/hr
Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...
Pompano Beach, FL · Remote
$50K - $65K/yr
Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...
Quick apply
Pompano Beach, FL · Remote
$50K - $65K/yr
Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...
Pompano Beach, FL · On-site
$50K - $65K/yr
Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...
Pompano Beach, FL · On-site
$50K - $65K/yr
Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...
Miami, FL · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI ...
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Miami, FL · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI ...
The Manager, Utilization Review is responsible for overseeing the daily operations of the ... Knowledge of healthcare regulations, insurance processes, and quality improvement methodologies.
The Manager, Utilization Review is responsible for overseeing the daily operations of the ... Knowledge of healthcare regulations, insurance processes, and quality improvement methodologies.
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Boca Raton, FL · On-site
$60K - $70K/yr
Utilization Review (UR) Specialist Location: Boca Raton, FL Job Type: Full-time, In-Person Pay: $60 ... Work collaboratively with insurance providers, care managers, clinicians, admissions teams, and ...
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Boca Raton, FL · On-site
$60K - $70K/yr
Utilization Review (UR) Specialist Location: Boca Raton, FL Job Type: Full-time, In-Person Pay: $60 ... Work collaboratively with insurance providers, care managers, clinicians, admissions teams, and ...
Must be familiar with a variety of insurances and funding streams, including commercial insurance ... Utilization Review position, such as: * Challenging and rewarding work environment * Competitive ...
Must be familiar with a variety of insurances and funding streams, including commercial insurance ... Utilization Review position, such as: * Challenging and rewarding work environment * Competitive ...
The Director of Utilization Management is also responsible for ensuring that the utilization review ... Must be familiar with a variety of insurances and funding streams, including commercial insurance ...
The Director of Utilization Management is also responsible for ensuring that the utilization review ... Must be familiar with a variety of insurances and funding streams, including commercial insurance ...
Fort Lauderdale, FL · Remote
$80K - $100K/yr
Setting: Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard ... Collaborate with physicians, case managers, and insurance payers * Support denial prevention ...
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Fort Lauderdale, FL · Remote
$80K - $100K/yr
Setting: Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard ... Collaborate with physicians, case managers, and insurance payers * Support denial prevention ...
Must have 2 years minimum experience in at least one of the following: utilization review from another managed care company; experience in a medical setting handling coordinating with insurance ...
Must have 2 years minimum experience in at least one of the following: utilization review from another managed care company; experience in a medical setting handling coordinating with insurance ...
PRN Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... and insurance offering, a physician network and various related services located all over the ...
PRN Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... and insurance offering, a physician network and various related services located all over the ...
PT Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... and insurance offering, a physician network and various related services located all over the ...
PT Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... and insurance offering, a physician network and various related services located all over the ...
Responsibilities The Utilization Review Director is responsible for directing and overseeing the ... insurance offering, a physician network and various related services located all over the U.S.
Responsibilities The Utilization Review Director is responsible for directing and overseeing the ... insurance offering, a physician network and various related services located all over the U.S.
Job Purpose: - The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible ... LifeStream Benefits * Health/Dental/Vision Insurance * Short Term Disability * Pension Plan ...
Job Purpose: - The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible ... LifeStream Benefits * Health/Dental/Vision Insurance * Short Term Disability * Pension Plan ...
| Aspect | Intern Insurance Utilization Review | Insurance Claims Processor |
|---|---|---|
| Credentials | Typically pursuing or holding a relevant degree (e.g., health administration, nursing) | High school diploma or equivalent; some roles may require insurance or claims processing certifications |
| Work Environment | Healthcare settings, insurance companies, or administrative offices | Insurance companies, healthcare providers, or claims processing centers |
| Primary Responsibilities | Assisting in reviewing medical necessity, supporting utilization review processes | Processing and reviewing insurance claims for accuracy and completeness |
Intern Insurance Utilization Review focuses on evaluating medical necessity and supporting healthcare decision-making, often involving review of patient records. Insurance Claims Processors handle the administrative task of reviewing and processing insurance claims for payment. While both roles involve insurance and healthcare, utilization review emphasizes clinical assessment, whereas claims processing centers on administrative claim management.
4.8
Based on 5 frontline employees who took The Breakroom Quiz
Behavioral Health Utilization Review Specialist I
Aspire Health Partners, Inc.
Make a Difference in Behavioral Health Care
At Aspire Health Partners, we are dedicated to transforming lives through compassionate, high-quality behavioral healthcare. As Florida’s largest nonprofit behavioral health provider, we serve diverse populations across Central Florida and are committed to clinical excellence and meaningful impact.
We are currently seeking a Utilization Review Specialist to join our team and play a key role in ensuring our clients receive the care they need while supporting effective coordination with insurance providers.
Position Summary
In this role, you will coordinate and manage insurance utilization review activities for hospitalized clients. You’ll work closely with clinical teams, insurance representatives, and internal departments to ensure timely authorizations, support treatment planning, and contribute to high-quality patient outcomes.
Key Responsibilities
Qualifications
Required:
Preferred:
Why Join Aspire?
Equal Opportunity Employer
Aspire Health Partners is a drug-free workplace and an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will be considered without regard to race, color, religion, national origin, sex, age, disability, or veteran status.
PI5b065a71482a-25405-32331851
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Health care and social assistance
501 - 1,000 Employees
Orlando, FL, US
2014