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Optum Chart Review Jobs in Texas (NOW HIRING)

UnitedHealth Group

Office Assistant

Tomball, TX · On-site

$16.85 - $25.25/hr

As members of the Optum family of businesses, we are dedicated to helping people feel their best ... Completes discharge chart reviews, performs audits, processes orders to/from physicians, and tracks ...

UMR

Associate Patient Care | , Texas

Mckinney, TX · On-site

Associate Patient Care Coordinator Optum is a global organization that delivers care, aided by ... Reviews missed visits daily submitted by field clinicians to ensure visits are re-scheduled ...

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Optum Chart Review information

What is an Optum Chart Review?

An Optum Chart Review is a process where medical records are examined by professionals working on behalf of Optum, a healthcare services and innovation company. The goal is to ensure that patient records are accurate, complete, and compliant with healthcare regulations. This review supports quality improvement, risk adjustment, and proper coding for insurance and billing purposes. Optum Chart Reviewers typically work with electronic health records (EHRs) and may collaborate with healthcare providers to clarify documentation.

What are some common challenges faced by professionals working in Optum Chart Review, and how can they be managed?

Professionals in Optum Chart Review often encounter challenges such as managing large volumes of medical records, ensuring the accuracy and completeness of data abstraction, and adhering to tight deadlines. Balancing productivity with quality is essential, as inaccuracies can impact patient care and organizational compliance. To manage these challenges, it’s important to stay organized, regularly communicate with team members or supervisors for clarification, and actively participate in ongoing training to keep up with the latest coding guidelines and regulatory requirements.

What are the key skills and qualifications needed to thrive as an Optum Chart Reviewer, and why are they important?

To thrive as an Optum Chart Reviewer, you need a strong background in medical coding, healthcare documentation review, and knowledge of clinical terminology, often supported by a relevant certification such as CPC or CRC. Familiarity with electronic health record (EHR) systems, chart abstraction tools, and compliance software is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for this role. These abilities ensure accurate data extraction, risk adjustment, and regulatory compliance, which are critical for optimizing patient care and supporting organizational goals.

What is the difference between Optum Chart Review vs Medical Records Reviewer?

AspectOptum Chart ReviewMedical Records Reviewer
CredentialsTypically requires healthcare-related certifications, such as RHIT, RHIA, or medical coding credentialsOften requires similar certifications, focusing on medical coding or health information management
Work EnvironmentRemote or office-based, working with healthcare data and patient recordsPrimarily office-based, reviewing and organizing medical records for accuracy and completeness
Employer & IndustryMajor healthcare companies like Optum, insurance providers, and healthcare organizationsHospitals, clinics, insurance companies, and health information management firms

Optum Chart Review and Medical Records Reviewer roles share similar credentials and work environments, focusing on healthcare data management. While both involve reviewing medical information, Optum Chart Review often emphasizes insurance claims and utilization review, whereas Medical Records Review centers on record accuracy and completeness. Understanding these differences helps job seekers identify the best fit for their skills and career goals.

What are popular job titles related to Optum Chart Review jobs in Texas?

For Optum Chart Review jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Optum Chart Review jobs in Texas look for?

The top searched job categories for Optum Chart Review jobs in Texas are:

What cities in Texas are hiring for Optum Chart Review jobs?

Cities in Texas with the most Optum Chart Review job openings:

Optum Chart Review jobs near you
Infographic showing various Optum Chart Review job openings in Texas as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution.

UR LVN Utilization/Clinical Claim Review | , | -Seybold Clinic

UnitedHealthcare

Pearland, TX • On-site

$20 - $36/hr

Other

Medical, Retirement

This job post has expired 1 day ago. Applications are no longer accepted.

UnitedHealthcare rating

7.8

Company rating: 7.8 out of 10

Based on 706 frontline employees who took The Breakroom Quiz

110th of 898 rated healthcare providers

Job description

Utilization Review Lvn Nurse

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

The Utilization Review LVN nurse will perform documentation review for medical necessity and benefit correlation of requested medical and surgical procedures, services and admissions for HMO, PPO and POS products. The UR LVN nurse will serve as facilitator of communication with clinic, payor and other customers.

Primary Responsibilities:

  • Data entry of all UR requests into the Kelsey-Seybold data system
  • Verifies eligibility
  • Obtains benefit interpretation from insurance company
  • Reviews request and chart to determine medical necessity by using internal criteria
  • Approves request or defers to insurance review and assists with MD review
  • Communicates with respective payor to obtain pre-certification authorization
  • Serves as resource to physicians, staff and patients regarding review process
  • Clarifies UR request discrepancies with office submitting or insurance company
  • Other duties as assigned

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Licensed Vocational Nurse
  • CEU requirement
  • TX LVN license
  • 2+ years of utilization review experience at heath plan, ACO, IPA, or provider group OR 3+ years of diverse clinical experience, including acute care or similar care
  • Good organization and communication skills
  • HMO, PPO and POS insurance knowledge
  • Valid Driver's license

Preferred Qualifications:

  • Computer and Coding experience

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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