ZipRecruiter

Log In

1

Quality Review Coordinator Jobs (NOW HIRING)

Birmingham

Quality Review Coordinator

Birmingham, AL · On-site

The Medical Review Unit develops, implements, and administers programs such as Medical Review and Preferred Medical Doctor, to determine medical necessity of services and impact cost savings.

National Medical Reviews

Review Coordinator

Warminster, PA · On-site

$65K - $70K/yr

Coordinates case review activities consistent with corporate policy and client-specific procedures ... Participates in quality improvement activities, as requested Education, Experience and Professional ...

National Medical Reviews

Review Coordinator

Warminster, PA · On-site

$65K - $70K/yr

Coordinates case review activities consistent with corporate policy and client-specific procedures ... Participates in quality improvement activities, as requested Education, Experience and Professional ...

UHS

Utilization Review Coordinator

Brookline, MA

Employees are part of a multi-disciplinary team of dynamic professionals providing high quality ... As the Utilization Review Coordinator, you will: * Complete initial precertification and concurrent ...

UHS

Utilization Review Coordinator

Brookline, MA

Employees are part of a multi-disciplinary team of dynamic professionals providing high quality ... As the Utilization Review Coordinator, you will: * Complete initial precertification and concurrent ...

UHS

Utilization Review Coordinator

Brookline, MA · On-site

Employees are part of a multi-disciplinary team of dynamic professionals providing high quality ... As the Utilization Review Coordinator, you will: * Complete initial precertification and concurrent ...

UHS

Utilization Review Coordinator

Augusta, GA · On-site

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management ... quality and cost-effective treatment is consistent with the mission, vision, and values of ...

UHS

Utilization Review Coordinator

Augusta, GA · On-site

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management ... quality and cost-effective treatment is consistent with the mission, vision, and values of ...

UHS

Utilization Review Coordinator

West Columbia, SC · On-site

... in quality behavioral health and substance abuse services for adolescents and adults. We offer a ... Coordinates the utilization management functions of a patient caseload through collaboration with ...

next page

Showing results 1-20

All JobsQuality Review JobsQuality Review Coordinator Jobs

Quality Review Coordinator information

See salary details

$14

$26

$43

How much do quality review coordinator jobs pay per hour?

As of Jul 20, 2026, the average hourly pay for quality review coordinator in the United States is $26.94, according to ZipRecruiter salary data. Most workers in this role earn between $20.19 and $31.25 per hour, depending on experience, location, and employer.

What are Quality Review Coordinators?

Quality Review Coordinators are professionals who oversee and assess the quality of products, services, or processes within an organization. They are responsible for ensuring that all standards and regulations are met, conducting audits and reviews, and identifying areas for improvement. Their work helps maintain compliance, improve efficiency, and support continuous quality improvement initiatives. Quality Review Coordinators often collaborate with various departments and provide feedback to help teams achieve quality objectives.

How does a Quality Review Coordinator typically collaborate with other departments to ensure compliance and process improvements?

A Quality Review Coordinator often works closely with teams such as operations, compliance, and training to monitor adherence to company policies and regulatory standards. They regularly communicate findings from audits or quality assessments to relevant stakeholders and may participate in cross-functional meetings to address recurring issues or implement process enhancements. This role requires strong interpersonal skills to provide constructive feedback and facilitate teamwork, ultimately driving continuous improvement across the organization.

What does a quality coordinator do?

A quality review coordinator is responsible for monitoring and evaluating products, services, or processes to ensure they meet quality standards. They review data, conduct audits, and collaborate with teams to implement improvements, often using quality management tools and documentation systems. This role requires attention to detail and knowledge of quality assurance procedures.

Is QA a good entry-level job?

Quality Review Coordinator roles are often suitable for entry-level candidates, especially those with strong attention to detail and basic understanding of quality standards. These positions typically require minimal prior experience and may involve training on specific tools or procedures, making them accessible for newcomers to the field.

What is the highest paying job as a coordinator?

The highest paying roles for coordinators often include senior or specialized positions such as Program Manager, Operations Manager, or Compliance Director, which typically require additional experience and certifications. These roles can offer higher salaries due to increased responsibilities and leadership requirements within organizations.

How much do quality coordinators make in the US?

Quality Review Coordinators in the US typically earn between $45,000 and $70,000 annually, depending on experience, location, and industry. Entry-level positions may start lower, while experienced coordinators with certifications can earn higher salaries. Many roles also include benefits such as health insurance and paid time off.

What are the key skills and qualifications needed to thrive as a Quality Review Coordinator, and why are they important?

To thrive as a Quality Review Coordinator, you need a strong background in quality assurance, data analysis, and process improvement, often supported by a degree in a related field such as healthcare or business. Familiarity with quality management systems, audit tools, and relevant certifications like Six Sigma or CPHQ is typically required. Attention to detail, problem-solving ability, and effective communication are crucial soft skills for collaborating with teams and ensuring compliance. These competencies are essential for maintaining high standards, identifying improvement opportunities, and ensuring organizational effectiveness.
More about Quality Review Coordinator jobs
What cities are hiring for Quality Review Coordinator jobs? Cities with the most Quality Review Coordinator job openings:
What states have the most Quality Review Coordinator jobs? States with the most job openings for Quality Review Coordinator jobs include:
What job categories do people searching Quality Review Coordinator jobs look for? The top searched job categories for Quality Review Coordinator jobs are:
Quality Review Coordinator jobs near you
Infographic showing various Quality Review Coordinator job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, 1% Temporary, and 1% Contract. Highlights an 83% Physical, 1% Hybrid, and 16% Remote job distribution, with an average salary of $56,028 per year, or $26.9 per hour.
Quality Review Coordinator

Quality Review Coordinator

Birmingham

Birmingham, AL

Other

Re-posted 22 days ago

Job description

BASIC FUNCTION

Perform and administer level 2 Medical Review Pre-Determinations according to benefit language and standard medical care.

ENVIRONMENT

The Health Managed Department is responsible for developing, implementing and administering private business and government utilization review, medical review, cost containment, reconsiderations, and post payment audit programs to assure optimization of cost savings to the company regarding medical claims. The Medical Review Unit develops, implements, and administers programs such as Medical Review and Preferred Medical Doctor, to determine medical necessity of services and impact cost savings.

WORKFLOW

Work is received via fax or mail from providers, groups and subscribers. Incumbent performs reviews of proposed procedures to approve reimbursement or denial of services. Incumbent performs special projects to investigate propriety of PMD and claims and assures PMD guidelines are followed. Incumbent provides weekly reports on request activities. Incumbent prepares reconsideration case for Level III review. The incumbent creates allow or reject on each contract for which a decision has been rendered. The incumbent researches and suggests changes to guides according to the most recent scientific literature.

KNOWLEDGE

Incumbent must have a thorough understanding of medical practice that can be obtained through a nursing degree program or experience required to obtain Registration (RN) from the state. The incumbent must know claims payment guidelines, billing guidelines, laws and contracts that govern the health insurance program administered by this corporation. The incumbent must be able to discuss coverage guidelines and benefit issues with physicians, group administrators, or internal customers. The incumbent must be able to assist groups in benefit design within the parameters of cost and standard medical care.

THINKING REQUIREMENTS:

The incumbent must be an independent thinker and therefore able to work closely via personal, written or oral communication with representatives and officials of public, private and governmental agencies and professionals inside and outside the Corporation. These groups include the provider financial and medical representatives, customer representatives, and Blue Cross and Blue Shield representatives.

INTERFACES AND INTERPERSONAL SKILLS:

Incumbent has contact with groups, providers and their office representatives, subscribers and internal departments involved with Marketing and claims processing. This contact is usually one to one. However, it can be in the form of a presentation to large audiences. Frequently, the provider or subscriber is frustrated and angry and incumbent must be able to establish effective communications to resolve problems.

AUTHORITY AND DECISION MAKING:

Incumbent decides medical necessity of particular procedure in accordance to contract limits and standard medical practice, and resolves problems for subscribers, groups and providers. Incumbent represents Blue Cross and Blue Shield of Alabama when performing before a large group.

PRINCIPAL ACCOUNTABLITIES
  • Activity: Perform medical and utilization predeterminations of PMD and/or non-PMD providers both in state and out.
    End Result: To determine if coding is correct and procedures filed were medically necessary in order to control and reduce medical care costs.
  • Activity: Respond to telephone or written requests for information from Subscribers and providers.
    End Result: To provide requested information to solve claims problems
  • Activity: Perform special projects with requested guidelines
    End Result: To investigate costs associated with PMD to assure compliance with PMD guidelines.
  • Activity: Prepare dialogue and support materials for workshops thorugh the state, as directed, for groups, agencies or providers.
    End Result: To educate groups, providers, and subscribers in total program concepts.
  • Activity: Assist in the development of new preferred care programs and their guidelines.
    End Result: To expand health management products, control costs and reduce overall medical expenses.

Apply