Identify problem areas and client issues and propose solutions to managers and partners. * Plan and ... Identify value added suggestions from audit and reviews for client utilization. * Meet budget and ...
Quick apply
Identify problem areas and client issues and propose solutions to managers and partners. * Plan and ... Identify value added suggestions from audit and reviews for client utilization. * Meet budget and ...
Tax Accountant
Cartersville, GA · On-site
Primary duty will be to manage, optimize a corporation's tax utilization strategy in compliance ... Minimum of 5 years of experience in tax, auditing, or related fields. * Experience with risk ...
Tax Accountant
Cartersville, GA · On-site
Primary duty will be to manage, optimize a corporation's tax utilization strategy in compliance ... Minimum of 5 years of experience in tax, auditing, or related fields. * Experience with risk ...
Primary duty will be to manage, optimize a corporation's tax utilization strategy in compliance ... Minimum of 5 years of experience in tax, auditing, or related fields. * Experience with risk ...
Primary duty will be to manage, optimize a corporation's tax utilization strategy in compliance ... Minimum of 5 years of experience in tax, auditing, or related fields. * Experience with risk ...
Property Administrator
Fort Stewart, GA · On-site
$18.25 - $24.50/hr
Auditing & Reporting: * Prepare and submit required property management reports (e.g., Loss, Damage, or Destruction [LDD] reports, utilization reports, and annual inventory certifications). * Support ...
Property Administrator
Fort Stewart, GA · On-site
$18.25 - $24.50/hr
Auditing & Reporting: * Prepare and submit required property management reports (e.g., Loss, Damage, or Destruction [LDD] reports, utilization reports, and annual inventory certifications). * Support ...
Sr Analyst, Benefits Planning
Oakwood, GA · On-site
$75K - $94K/yr
Financial Management & Analytics * Own enterprise-wide financial strategy and performance for ... Analyze cost drivers, utilization patterns, and long-term financial risks; translate insights into ...
Sr Analyst, Benefits Planning
Oakwood, GA · On-site
$75K - $94K/yr
Financial Management & Analytics * Own enterprise-wide financial strategy and performance for ... Analyze cost drivers, utilization patterns, and long-term financial risks; translate insights into ...
Sr Analyst, Benefits Planning
Oakwood, GA · On-site
$75K - $94K/yr
Financial Management & Analytics * Own enterprise-wide financial strategy and performance for ... Analyze cost drivers, utilization patterns, and long-term financial risks; translate insights into ...
Sr Analyst, Benefits Planning
Oakwood, GA · On-site
$75K - $94K/yr
Financial Management & Analytics * Own enterprise-wide financial strategy and performance for ... Analyze cost drivers, utilization patterns, and long-term financial risks; translate insights into ...
... and utilization of Personal Protective Equipment Phase 3 - Supervision, Quality and Compliance ... surrounding auditing, testing, installation and maintenance safety and code compliance Manage ...
... and utilization of Personal Protective Equipment Phase 3 - Supervision, Quality and Compliance ... surrounding auditing, testing, installation and maintenance safety and code compliance Manage ...
Coding Provider Liaison
Atlanta, GA · On-site
The Coding Provider Liaison (Professional Coding Auditor & Educator) works collaboratively with ... appropriate utilization, clinical severity, outcomes and quality is captured for the level of ...
Coding Provider Liaison
Atlanta, GA · On-site
The Coding Provider Liaison (Professional Coding Auditor & Educator) works collaboratively with ... appropriate utilization, clinical severity, outcomes and quality is captured for the level of ...
The Coding Provider Liaison (Professional Coding Auditor & Educator) works collaboratively with ... appropriate utilization, clinical severity, outcomes and quality is captured for the level of ...
Quick apply
The Coding Provider Liaison (Professional Coding Auditor & Educator) works collaboratively with ... appropriate utilization, clinical severity, outcomes and quality is captured for the level of ...
Clinical Administrative Assistant
$17.75 - $23.75/hr
... staff schedules, manages clinical group referrals and census, supports auditing and quality ... Track and report group attendance, census, and utilization metrics. * Support accreditation ...
Clinical Administrative Assistant
$17.75 - $23.75/hr
... staff schedules, manages clinical group referrals and census, supports auditing and quality ... Track and report group attendance, census, and utilization metrics. * Support accreditation ...
Inventory Control Manager I
Lithia Springs, GA · On-site
$85K - $150K/yr
... management. Business benefits of the role: * Ensuring the right product is in the right place at ... Proper utilization of information technology * Provide required documentation to customer, customer ...
Inventory Control Manager I
Lithia Springs, GA · On-site
$85K - $150K/yr
... management. Business benefits of the role: * Ensuring the right product is in the right place at ... Proper utilization of information technology * Provide required documentation to customer, customer ...
Inventory Control Manager I
Lithia Springs, GA · On-site
$85K - $150K/yr
... management. Business benefits of the role: * Ensuring the right product is in the right place at ... Proper utilization of information technology * Provide required documentation to customer, customer ...
Inventory Control Manager I
Lithia Springs, GA · On-site
$85K - $150K/yr
... management. Business benefits of the role: * Ensuring the right product is in the right place at ... Proper utilization of information technology * Provide required documentation to customer, customer ...
You will gain direct experience with the essential tools of the trade--auditing data health in ... utilization. * Data & Contact Management: Support ongoing contact management and clean-up efforts ...
Quick apply
You will gain direct experience with the essential tools of the trade--auditing data health in ... utilization. * Data & Contact Management: Support ongoing contact management and clean-up efforts ...
You will gain direct experience with the essential tools of the trade--auditing data health in ... utilization. * Data & Contact Management: Support ongoing contact management and clean-up efforts ...
You will gain direct experience with the essential tools of the trade--auditing data health in ... utilization. * Data & Contact Management: Support ongoing contact management and clean-up efforts ...
Operations Management Program
Atlanta, GA · On-site
$85K/yr
... and utilization of Personal Protective Equipment Phase 3 - Supervision, Quality and Compliance ... auditing, testing, installation and maintenance safety and code compliance • Manage limited ...
Operations Management Program
Atlanta, GA · On-site
$85K/yr
... and utilization of Personal Protective Equipment Phase 3 - Supervision, Quality and Compliance ... auditing, testing, installation and maintenance safety and code compliance • Manage limited ...
Accountant
Alpharetta, GA · Hybrid
$53K - $70K/yr
... management reports. * Support accounts payable, accounts receivable, and fixed asset accounting ... Compile and organize documentation requested by external auditors and tax advisors. * Help ensure ...
Quick apply
Accountant
Alpharetta, GA · Hybrid
$53K - $70K/yr
... management reports. * Support accounts payable, accounts receivable, and fixed asset accounting ... Compile and organize documentation requested by external auditors and tax advisors. * Help ensure ...
... utilization of professional networks, and participation in business and industry organizations ... Proven project management skills, with a track record of successfully leading large-scale projects ...
Quick apply
... utilization of professional networks, and participation in business and industry organizations ... Proven project management skills, with a track record of successfully leading large-scale projects ...
... utilization of professional networks, and participation in business and industry organizations ... Proven project management skills, with a track record of successfully leading large-scale projects ...
Quick apply
... utilization of professional networks, and participation in business and industry organizations ... Proven project management skills, with a track record of successfully leading large-scale projects ...
Internal Revenue Agent (Employee Plans Agent)
Atlanta, GA · On-site
$74K/yr
... management, or finance. OR a combination of education and experience equivalent to 4 years that ... Qualifying experience in accounting, auditing, tax, financial, legal, or other fields to ...
Internal Revenue Agent (Employee Plans Agent)
Atlanta, GA · On-site
$74K/yr
... management, or finance. OR a combination of education and experience equivalent to 4 years that ... Qualifying experience in accounting, auditing, tax, financial, legal, or other fields to ...
Internal Revenue Agent (Employee Plans Agent)
Atlanta, GA · On-site
$74K/yr
... management, or finance. OR a combination of education and experience equivalent to 4 years that ... Qualifying experience in accounting, auditing, tax, financial, legal, or other fields to ...
Internal Revenue Agent (Employee Plans Agent)
Atlanta, GA · On-site
$74K/yr
... management, or finance. OR a combination of education and experience equivalent to 4 years that ... Qualifying experience in accounting, auditing, tax, financial, legal, or other fields to ...
Utilization Management Auditor information
What is a utilization management auditor?
A Utilization Management Auditor is a healthcare professional responsible for reviewing medical records, claims, and utilization data to ensure that healthcare services provided to patients are necessary, appropriate, and comply with established guidelines and policies. They help identify overuse, underuse, or misuse of medical resources and ensure regulatory compliance. Utilization Management Auditors work closely with healthcare providers, insurance companies, and regulatory agencies to improve the quality and cost-effectiveness of patient care.
What are the key skills and qualifications needed to thrive as a utilization management auditor?
To thrive as a Utilization Management Auditor, you need a strong background in healthcare administration, case management, and medical coding, often supported by a clinical degree or certification such as RN, LPN, or RHIA. Familiarity with utilization management software, electronic health records (EHRs), and regulatory standards like CMS guidelines is essential. Analytical thinking, attention to detail, and effective communication are crucial soft skills for identifying compliance issues and collaborating with healthcare teams. These skills ensure accurate audits, regulatory compliance, and optimal resource utilization within healthcare organizations.
What are some common challenges faced by utilization management auditors and how can they be addressed?
Utilization Management Auditors often encounter challenges such as keeping up with constantly changing healthcare regulations and payer requirements, interpreting complex medical documentation, and ensuring compliance with both internal and external policies. To address these challenges, auditors should engage in ongoing professional development, collaborate closely with clinical and administrative teams for accurate information, and make use of robust audit tools and resources. Effective communication and a proactive approach to regulatory changes can help streamline the audit process and maintain high standards of accuracy.
What is the difference between Utilization Management Auditor vs Utilization Review Nurse?
| Aspect | Utilization Management Auditor | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license, certifications like CCM or CUC | Licensed Registered Nurse (RN), often with additional certifications |
| Work Environment | Office-based, insurance companies, healthcare organizations | Hospital, clinics, insurance companies, often in clinical settings |
| Primary Focus | Auditing and reviewing utilization data for compliance and cost management | Assessing patient care needs and determining appropriate services |
While both roles involve healthcare utilization, the Utilization Management Auditor primarily reviews data for compliance and cost efficiency, whereas the Utilization Review Nurse focuses on patient care assessments. Both require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ.
What are popular job titles related to Utilization Management Auditor jobs in Georgia?
For Utilization Management Auditor jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Utilization Management Auditor jobs in Georgia look for?
The top searched job categories for Utilization Management Auditor jobs in Georgia are:
Job description
Public Audit Senior
Click here to apply online
Essential Functions & Responsibilities:
- Adhere to the highest degree of professional standards and strict client confidentiality.
- To successfully complete the CPA exam and obtain the necessary hours to become a CPA if not already licensed.
- Demonstrate professional interest in providing clients with quality services and personal attention by performing “above and beyond the call of duty” if necessary.
- Ability and desire to run client engagements from start to finish, which includes planning, executing, directing, and completing audits, and other service offerings and managing to budget.
- Be involved in evaluating and making recommendations for improvement regarding safeguarding of assets, compliance with policies and procedures, reliability of financial statements and underlying records, and efficiency and effectiveness of operations.
- Identify problem areas and client issues and propose solutions to managers and partners.
- Plan and prepare supporting audit workpaper schedules and file memos.
- Effectively wrap-up audit engagements.
- Identify value added suggestions from audit and reviews for client utilization.
- Meet budget and realization goals.
- Meet chargeable hour goal by advising team members of availability and monitoring progress toward goal.
- Effectively communicate with clients as required.
- Apply basic accounting and auditing and tax knowledge to more complex and multiple projects.
- Take personal initiatives to develop career path.
- Supervise, train, and mentor associates in audit and review process.
- Become involved in staff and intern development.
- Be aware of developments, pronouncements and research technical issues.
- Identify technical skills needed for improvement and improve through CPE, personal commitment and on-the-job training.
- Be proficient in use of computers and become proficient with firm utilized paperless audit software.
Qualifications Required:
- A Bachelor’s Degree in Accounting
- Two years of previous public accounting experience with an emphasis on auditing
- Strong analytical, problem-solving, interpersonal and communication skills
- Ability to supervise staff and lead projects
- CPA License OR Completed educational requirements for CPA License
Qualifications Desired
- Experience and desire to audit non-profit entities
- Experience with federal compliance audits performed under OMB Uniform Guidance and Government Auditing Standards (Yellow Book).
Click here to apply online
About Staff Financial Group
Sourced by ZipRecruiter
Industry
Recruiting and staffing services
Company size
11 - 50 Employees
Headquarters location
Cumming, GA, US
Year founded
2003