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Part Time Insurance Utilization Review Jobs in Missouri

Encompass Health Corporation

Case Manager

Ballwin, MO · On-site

$19.50 - $25/hr

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.

Encompass Health Corporation

Case Manager

Columbia, MO · On-site

$19 - $24.50/hr

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.

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All JobsInsurance Utilization Review JobsPart Time Insurance Utilization Review JobsPart Time Insurance Utilization Review Jobs in Missouri

Part Time Insurance Utilization Review information

What is the difference between Part Time Insurance Utilization Review vs Part Time Claims Reviewer?

AspectPart Time Insurance Utilization ReviewPart Time Claims Reviewer
CredentialsTypically requires insurance or healthcare-related certificationsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare settings, insurance companies, or third-party administratorsInsurance companies, claims processing centers, or third-party administrators
Job FocusEvaluating medical necessity and appropriateness of servicesReviewing and processing insurance claims for accuracy and coverage

Part Time Insurance Utilization Review and Part Time Claims Reviewer roles both involve insurance industry work, but focus on different aspects. Utilization review centers on assessing medical necessity, while claims reviewers handle processing and verifying claims. Understanding these differences helps job seekers find the right fit based on their skills and interests.

What are the most commonly searched types of Insurance Utilization Review jobs in Missouri? The most popular types of Insurance Utilization Review jobs in Missouri are:
What cities in Missouri are hiring for Part Time Insurance Utilization Review jobs? Cities in Missouri with the most Part Time Insurance Utilization Review job openings:
Part Time Insurance Utilization Review jobs near you
RN, Utilization Review - PRN

RN, Utilization Review - PRN

Saint Luke's Hospital of Kansas City

Kansas City, MO • Remote

Part-time

This job post has expired 2 days ago. Applications are no longer accepted.

Saint Luke's Health System (Kansas City) rating

7.1

Company rating: 7.1 out of 10

Based on 109 frontline employees who took The Breakroom Quiz

375th of 890 rated healthcare providers

Job description

Job DescriptionSaint Luke's is looking to add to the UR team!

Schedule: Day Shift

Status: PRN - 1 shift required every 2 weeks

  • MO/KS RN license required

  • Case Management experience preferred

  • Min of 2 years bedside experience preferred

  • Remote position; will cover all campuses

The Opportunity:

The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical outcomes through utilization review and management. This position includes monitoring patient charts and utilization of health care services. Collaborates and communicates with physicians, Care Coordinators, Social Workers and other members of the multidisciplinary and revenue cycle teams.

  • Completes initial and concurrent reviews; identifies appropriate level of service and length of stay, using clinical guidelines (InterQual).

  • Complies with CMS regulation regarding utilization review/management.

  • Obtains and manages insurance authorizations and proactively works denials to help mitigate financial impact.

  • Submits referrals for secondary level review as appropriate and follows through on process.

  • Documents communication and work in electronic medical record.

  • Works with physicians and members of the multidisciplinary and revenue cycle teams to ensure appropriate level of service, level of care and billing.

Why Saint Luke's?

  • We believe in work/life balance.

  • We are dedicated to innovation and always looking for ways to improve.

  • We believe in creating a collaborative environment where all voices are heard.

  • We are here for you and will support you in achieving your goals.

Job Requirements

Applicable Experience:

Less than 1 yearRegistered Nurse - VariousAssociate DegreeJob DetailsPRNDay (United States of America)

The best place to get care. The best place to give care. Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

What Saint Luke's Health System (Kansas City) employees say

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