ZipRecruiter

Log In

1

Intern Insurance Utilization Review Jobs in Kansas

Gianteagle

Pharmacy Intern - Girard Giant Eagle

Girard, KS · On-site

$12.75 - $15.75/hr

Enter patient personal data and insurance information. * Enter all prescription information ... Alert pharmacists appropriately for drug utilization reviews, calling and resolving third party ...

CVS Health

Pharmacy Intern - Grad

Lawrence, KS

$15.75 - $19.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

ProviDRs Care

Registered Nurse (RN) Supervisor

Wichita, KS · On-site

$70K - $85K/hr

Utilization Review RNs, RN Case Managers, Medical Assistant Care Navigators This position is ... Benefits Medical insurance Dental insurance Vision insurance Employer-paid life insurance Employee ...

Oak St. Health

Grad Pharmacist

Olathe, KS · On-site

$16.25 - $20/hr

Graduate Pharmacy Intern You've invested a lot of time and energy in your education. Now you want ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

Oak St. Health

Grad Pharmacist

Salina, KS · On-site

$16 - $19.75/hr

Graduate Pharmacy Intern You've invested a lot of time and energy in your education. Now you want ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

Oak St. Health

Grad Pharmacist

Wichita, KS · On-site

$16.50 - $20.50/hr

Graduate Pharmacy Intern You've invested a lot of time and energy in your education. Now you want ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

Oak St. Health

Grad Pharmacist

Shawnee, KS · On-site

$15.75 - $19.75/hr

Graduate Pharmacy Intern You've invested a lot of time and energy in your education. Now you want ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

CVS Health

Grad Pharmacist

Wichita, KS · On-site

$15 - $18.50/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

CVS Health

Grad Pharmacist

Salina, KS · On-site

$16 - $19.75/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

CVS Health

Grad Pharmacist

Olathe, KS

$16.25 - $20/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

CVS Health

Grad Pharmacist

Shawnee, KS · On-site

$15.75 - $19.75/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

CVS Health

Grad Pharmacist

Salina, KS · On-site

$16 - $19.75/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

CVS Health

Grad Pharmacist

Wichita, KS · On-site

$16.50 - $20.50/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

CVS Health

Grad Pharmacist

Olathe, KS · On-site

$16.25 - $20/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

CVS Health

Grad Pharmacist

Shawnee, KS

$15.75 - $19.75/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

next page

Showing results 1-20

All JobsIntern Insurance Utilization Review JobsIntern Insurance Utilization Review Jobs in Kansas

Intern Insurance Utilization Review information

What does an intern insurance utilization review do?

An Intern Insurance Utilization Review assists with evaluating medical records and insurance claims to ensure that healthcare services are medically necessary and covered by insurance policies. They work under supervision to review documentation, communicate with healthcare providers, and help determine if treatments meet established guidelines. This role provides valuable exposure to the insurance and healthcare industries, helping interns learn about claims processing, policy compliance, and the importance of cost-effective care.

What skills and qualifications are needed to thrive as an intern insurance utilization review?

To thrive as an Intern in Insurance Utilization Review, you typically need a background in healthcare administration or a related field, along with strong analytical and organizational skills. Familiarity with electronic health records (EHRs), insurance databases, and claims processing systems is often required. Attention to detail, effective communication, and the ability to collaborate with both clinical and administrative teams are essential soft skills. These competencies ensure accurate review of insurance claims, compliance with regulations, and efficient coordination between healthcare providers and insurers.

What is the difference between Intern Insurance Utilization Review vs Insurance Claims Processor?

AspectIntern Insurance Utilization ReviewInsurance Claims Processor
CredentialsTypically 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 EnvironmentHealthcare settings, insurance companies, or administrative officesInsurance companies, healthcare providers, or claims processing centers
Primary ResponsibilitiesAssisting in reviewing medical necessity, supporting utilization review processesProcessing 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.

How do I get into an intern insurance utilization review?

To become an intern in insurance utilization review, candidates typically need to be enrolled in or have recently completed a relevant healthcare or insurance-related program, such as health administration or nursing. Gaining knowledge of medical terminology, insurance policies, and utilization review processes, along with strong analytical skills, is important; some positions may require certification or training in healthcare quality or case management. Internships are often offered through insurance companies, healthcare organizations, or hospitals and may require applying through their career portals or internship programs.

Is utilization review a stressful job?

Utilization review as an intern involves evaluating insurance claims and determining appropriate care, which can be demanding due to strict deadlines and the need for accuracy. The role requires attention to detail and knowledge of insurance policies, but stress levels vary depending on workload and individual coping skills.

What are the most commonly searched types of Insurance Utilization Review jobs in Kansas?

The most popular types of Insurance Utilization Review jobs in Kansas are:

What cities in Kansas are hiring for Intern Insurance Utilization Review jobs?

Cities in Kansas with the most Intern Insurance Utilization Review job openings:

Intern Insurance Utilization Review jobs near you

Utilization Reviewer

Bert Nash Community Mental Health Center

Lawrence, KS • On-site

$65K - $70K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

Bert Nash Community Mental Health Center rating

6.2

Company rating: 6.2 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

Utilization Reviewer
Pay is commensurate with experience within a range of $65,000 to $70,000 annually. Full time, exempt, benefits eligible. Bert Nash offers excellent benefits which include medical, dental, vision, KPERS retirement, life insurance, an Employee Assistance Program (EAP) providing free counseling and resources, and generous PTO.
Caring. Hope. Giving back. Our mission at the Bert Nash Center as the Community Mental Health Center (CMHC) of Douglas County is to advance the health of the community through comprehensive behavioral health services responsive to evolving needs and changing environments. We accomplish this by believing in our team. Each person that works for the Bert Nash Center contributes directly to the success of our clients, organization, and community. Our values of compassion, integrity, equity and hope reflect in everything we do.
The Utilization Reviewer's primary responsibility is to manage and complete monthly clinical record reviews to ensure provision of clinically appropriate care is delivered to clients in the least restrictive but clinically appropriate level as quickly as possible while complying with agency, payers, applicable policies, regulations and accreditation standards. This role's overall goal is to ensure that quality services are provided in the most efficient, cost-effective manner to all eligible clients seeking treatment regardless of the treatment setting or payer.
Responsibilities: The primary responsibility of the Utilization Reviewer is to ensure clinical documentation achieves expected standards, implement and train for consistency in best practices across the organization's facilities, participate and coordinate with teams Quality Improvement Plans or related initiatives. Duties will include but not limited to:
  • Conduct monthly clinical chart reviews to assure clients receive clinically appropriate care and complies with agency, payor, applicable policies, regulations and accreditation standards.
  • Utilize evidence-based calculation to ensure the sample size of charts reviewed provide a high confidence level that results are valid and reliable.
  • Provide chart review results to program directors or managers with both aggregate program data and individual charts needing remediation.
  • Work with directors or program managers on remediation activities to ensure they are completed within 30 days.
  • Meet with teams to help identify and develop continuous quality improvement goal(s) to improve the quality of documentation.
  • Managing organizational risks through implementation and improvement of best practices in clinical documentation, CCBHC regulations, CARF standards and other regulatory requirements.
  • Provide or coordinate the provision of related trainings in collaboration with the Clinical Consultant, Clinical Educator, and other team members.
  • Provides response to clinical quality questions.
  • Champions continuous quality improvement and assists in developing, tracking, and realizing related organizational goals or objectives.
  • Assign, analyze and present the quarterly chart review data for all teams per CARF Standards 2.G. and 2.H.
  • Analyzes monthly chart reviews to identify both areas needing improvement and areas that have improved since previous audits.
  • Maintain and record inventories of chart review occurrences and results.
Qualifications include but not limited to:
  • Licensure in social work, counseling, nursing or psychology.
  • Knowledge and familiarity with electronic health record (EHR) documentation.
  • Three years of experience providing billed services to clients in fields such as nursing, counseling, psychology, therapy, medication management, case management, or other.
  • Master's degree in behavioral health, medical services or administration, nursing, psychology, sociology, or similar.
  • Ability to accurately interpret standards from policies, contracts, and accrediting bodies for implementation.
  • Flexibility in assigned working hours.
  • Ability to negotiate, complete contracted work, analyze operations, and governmental/accrediting body regulations.
  • Interest or experience in quality improvement, quality assurance, or similar background and/or training a plus.
  • Have exemplary existing skills in clinical documentation and familiarity with using EHRs to complete documentation reviews, as well as external tools such as the Microsoft Office Suite.
  • Assist QI team with other duties as needed.

What Bert Nash Community Mental Health Center employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply