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Utilization Review Administrative Assistant Jobs

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ADMINISTRATIVE ASSISTANT

Columbus, OH · On-site

$17.50 - $23.50/hr

To organize, prepare, and review administrative reports; and to assist with preparing reports for presentation. This position will have access to and regularly will work with information of the most ...

New

UHS

Utilization Review Coordinator

Mountain City, TN · On-site

We are a 120-bed residential treatment facility and assist in the evaluation, diagnosis, and ... Bachelor's Degree preferred. * 1+ year(s) of related administrative or healthcare experience.

UHS

Utilization Review Coordinator

Mountain City, TN · On-site

We are a 120-bed residential treatment facility and assist in the evaluation, diagnosis, and ... Bachelor's Degree preferred. * 1+ year(s) of related administrative or healthcare experience.

Gateway Rehab

Utilization Review Liaison - REMOTE

In this important administrative and clinical support role, you will help ensure patients receive ... Investigate denied claims and assist in efforts to recover payment for services rendered. * Attend ...

UHS

Utilization Review Coordinator

Mountain City, TN · On-site

We are a 120-bed residential treatment facility and assist in the evaluation, diagnosis, and ... Bachelor's Degree preferred. * 1+ year(s) of related administrative or healthcare experience.

UHS

Utilization Review Coordinator

Mountain City, TN · On-site

We are a 120-bed residential treatment facility and assist in the evaluation, diagnosis, and ... Bachelor's Degree preferred. * 1+ year(s) of related administrative or healthcare experience.

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Utilization Review Administrative Assistant information

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How much do utilization review administrative assistant jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for utilization review administrative assistant in the United States is $21.04, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.32 per hour, depending on experience, location, and employer.

What does a utilization review administrative assistant do?

A Utilization Review Administrative Assistant supports the utilization review team by handling administrative tasks related to patient care authorization and insurance verification. They assist with preparing and maintaining records, submitting necessary documentation to insurance companies, and communicating with healthcare providers about patient cases. Their role ensures that all paperwork and processes comply with healthcare regulations, helping to facilitate efficient reviews and approvals for patient services.

What skills and qualifications are needed to be a utilization review administrative assistant?

To thrive as a Utilization Review Administrative Assistant, you need strong organizational skills, attention to detail, and familiarity with healthcare terminology, typically supported by a high school diploma or associate degree. Proficiency with medical records systems, Microsoft Office Suite, and utilization review software is commonly required. Excellent communication, multitasking, and problem-solving abilities help you coordinate efficiently with clinical staff and insurance providers. These skills are crucial for ensuring accurate documentation, effective case management, and compliance with healthcare regulations.

How does a utilization review administrative assistant contribute to the utilization review process?

A Utilization Review Administrative Assistant plays a key role by managing documentation, scheduling case reviews, and ensuring that all necessary medical records are accurately prepared and available for the clinical review team. They coordinate communication between providers, insurance companies, and internal staff, which helps streamline the approval process for medical services. By handling these administrative tasks efficiently, they enable clinicians to focus on making timely, informed decisions, directly impacting the overall workflow and patient care outcomes.

How do I get into a utilization review administrative assistant?

To become a utilization review administrative assistant, candidates typically need a high school diploma or equivalent, along with strong organizational and communication skills. Relevant experience in healthcare or administrative roles, familiarity with medical terminology, and proficiency in office software can improve job prospects; some positions may also require certification in healthcare administration or utilization review processes.

What cities are hiring for Utilization Review Administrative Assistant jobs?

Cities with the most Utilization Review Administrative Assistant job openings:

What states have the most Utilization Review Administrative Assistant jobs?

States with the most job openings for Utilization Review Administrative Assistant jobs include:

What are popular job titles related to Utilization Review Administrative Assistant jobs?

For Utilization Review Administrative Assistant jobs, the most frequently searched job titles are:

Infographic showing various Utilization Review Administrative Assistant job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $43,768 per year, or $21 per hour.

Utilization Review Nurse

Kotzebue, AK • On-site

Maniilaq Association
501 - 1,000 employees
Learn more about Maniilaq Associationexternal

Other

Re-posted 11 days ago

Job description

Maniilaq Association is a P.L. 93-638 Native/Indian Preference/EEO Employer
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Utilization Review Nurse Job Code: 2026:OTZ-201 Location: Kotzebue, Alaska Program: Nursing Division FT/PT Status: Full Time Job Responsibilities:
MANIILAQ ASSOCIATION
5/2026
Title: Utilization Management Nurse Pay Grade: 31
Program: Nursing Status: Exempt
Housing Priority: 3 Covered: Yes
POSITION SUMMARY
The Utilization Management Nurse (UMN) is responsible for performing Utilization Review and managing risk, coordinates and facilitates with departmental staff on Durable Medical Equipment (DME), and pharmacy prior authorizations. THE UMN works with the medical treatment and case management team in the coordination of patient care including the development of new operational changes and new services to ensure compliance and risk mitigation. The UMN will use a process that includes screening and case finding, comprehensive multidimensional assessment, connection with available resources, implementation of the plan and ongoing monitoring and re-assessment/follow-up. The UMN assists with the Quality and Case Management programs and, coordinates the IPC4 program. This position reports directly to the Chief Nursing Officer or designee.
PRINCIPAL DUTIES AND RESPONSIBILITIES
  1. Coordinates the IPC4 process in Medicare/Medicaid and private insurances.
  2. Assists in revenue procurement by:making sure insurance approvals are completed correctly with no penalty; helping to identify alternate resources of funding such as VA, Denali Kid Care, Medicare, and Medicaid; and monitoring the appeal process when claims are denied.
  3. Chairs Quarterly Utilization Review Committee meetings to improve utilization of resources and improve patient care.
  4. Submits Quarterly reports to CMO and CNO for Board of Director meetings.
  5. Works closely with Coders and Billers to insure accurate, timely billing information.
  6. Completes Utilization Review processes as assigned.
  7. Oversees development and maintenance of a resource database of Federal, State, community, and institutional resources.
  8. Assists in arranging team conferences and networks for relationship building and resource development with village leaders, Community Health Aides/Practitioners, MHC Medical Staff, MHC Nursing Staff, private insurance contacts, Medicaid/Medicare contacts, ANMC Providers, and the CM/SC/UR Team.
  9. Participates on improvement projects as assigned.
  10. Participates in Medicaid Task Force committee through Alaska Native Health Board.
  11. Completes Quality Improvement, Quality Assurance and Performance Improvement projects and tasks as assigned.
  12. Utilizes team building, problem solving skills and lean principles in the on-going quality improvement initiatives.
  13. Identify, assess, and monitor potential clinical, operational, and compliance risks within the Utilization Review and Case Management programs.
  14. Report and document incidents, near-misses, and adverse events in accordance with organizational policy and regulatory standards.
  15. Participate in root cause analyses and collaborate with leadership to implement corrective action plans to mitigate future risks.
  16. Collaborate with the Risk Management team to review, update, and communicate policies and procedures relevant to utilization review and patient care coordination.
  17. Educate clinical and administrative staff on risk awareness, safety protocols, and compliance requirements.
  18. Coordinate and facilitate prior authorizations for DME by collaborating with patients, clinical staff and providers to ensure clients' needs are met.
  19. Collaborate with providers and pharmacist process prior authorizations for specialized high-cost medications; monitor appeal process if claims are denied.
Job Qualifications:
MINIMUM REQUIREMENTS
Current licensure as a RN with at least two years of Case Management, Utilization Review, Discharge Planning or Quality Improvement experience preferred. Knowledge of acute and chronic illnesses, specialty clinic procedures, and community health nursing. Must be able to pass the core competencies assigned to this position and maintain the educational requirements of the program. Ability to utilize various computer programs, including Cerner and Microsoft Office. Demonstrates a wide theory base in order to interact in an effective manner with physicians, health team members, community agencies, and clients/families with diverse opinions, values, and religious and cultural ideals. Ability to work autonomously with little direction and be directly accountable for practice. Knowledge of and experience working with all regulatory, state, and federal agencies.
Other Job Information (if applicable):
DISCLAIMER
The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be considered an exhaustive list of all responsibilities, duties and skills required of personnel in this job, and the employer reserves the right to revise or change this description. This description does not constitute a written or implied contract of employment. To perform this job successfully, an individual must be able to satisfactorily perform each of the above essential duties and meet physical demands. Reasonable accommodations may be made to enable individuals with disabilities to meet those conditions.

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