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Utilization Review Assistant Jobs in Illinois (NOW HIRING)

Riverside Healthcare

PHYSICIAN ADVISOR

Kankakee, IL · On-site

Stay current on changes in payer rules including CMS rules as it pertains to utilization review ... Apply medical expertise to assist with appropriate billing for services * Provide feedback on payer ...

Riverside Healthcare

PHYSICIAN ADVISOR

Kankakee, IL · On-site

$95.38/hr

Stay current on changes in payer rules including CMS rules as it pertains to utilization review ... Apply medical expertise to assist with appropriate billing for services * Provide feedback on payer ...

Redwood Logistics

Legal Assistant

Chicago, IL · On-site +1

$50K - $60K/yr

Identify potential risks associated with contracts under review; * Assist with utilization of the organizations new contract life-cycle management software (CLM); * Focus on the continual improvement ...

United Community Bank

Credit Review Manager

Chatham, IL · On-site

$110K - $150K/yr

... staff. Assist with the oversight of all other human resource functions with supervised staff. Submit periodic written staff personnel reviews. Assures effective utilization of supervised staff

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All JobsUtilization Review JobsUtilization Review Assistant JobsUtilization Review Assistant Jobs in Illinois

Utilization Review Assistant information

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How much do utilization review assistant jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for utilization review assistant in Illinois is $27.15, according to ZipRecruiter salary data. Most workers in this role earn between $15.40 and $33.33 per hour, depending on experience, location, and employer.

What is a utilization review assistant?

A Utilization Review Assistant supports the utilization review process by reviewing medical records, verifying insurance coverage, and ensuring that healthcare services meet necessary guidelines. They assist in gathering documentation, communicating with insurance providers, and coordinating with medical staff to facilitate approvals for treatments. Their role helps ensure that healthcare services are provided efficiently while maintaining compliance with insurance policies and regulations.

What does a utilization review assistant do?

A Utilization Review Assistant typically spends their day reviewing medical records, verifying patient information, and ensuring documentation meets insurance or regulatory requirements. They often work closely with nurses, physicians, case managers, and billing staff to collect necessary data and clarify documentation. The work is usually performed in an office within a hospital, clinic, or insurance company, where prioritizing tasks and maintaining confidentiality are key. This collaborative, detail-oriented environment provides a valuable introduction to healthcare administration and can open doors to broader roles in utilization management or case management.

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

To thrive as a Utilization Review Assistant, you need attention to detail, basic understanding of medical terminology, strong organizational skills, and typically a high school diploma or equivalent. Familiarity with healthcare management software and electronic health records (EHR) systems, along with experience in data entry, is important for this role. Strong communication, problem-solving abilities, and a customer service-oriented attitude help you excel when interacting with clinical staff and patients. These skills are essential for ensuring accurate review processes, compliance with regulations, and effective coordination within healthcare teams.

How do I get into a utilization review assistant?

To become a utilization review assistant, candidates typically need a high school diploma or equivalent, with some roles preferring healthcare-related certifications or experience. Strong organizational skills, attention to detail, and familiarity with medical records and insurance processes are important; some positions may require knowledge of healthcare management software. Gaining relevant experience or certifications can improve job prospects in this field.

What are the most commonly searched types of Utilization Review jobs in Illinois?

The most popular types of Utilization Review jobs in Illinois are:

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

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

What job categories do people searching Utilization Review Assistant jobs in Illinois look for?

The top searched job categories for Utilization Review Assistant jobs in Illinois are:

What cities in Illinois are hiring for Utilization Review Assistant jobs?

Cities in Illinois with the most Utilization Review Assistant job openings:

Utilization Review Assistant jobs near you
Infographic showing various Utilization Review Assistant job openings in Illinois as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $56,480 per year, or $27.2 per hour.

PHYSICIAN ADVISOR

Riverside Healthcare

Kankakee, IL • On-site

Other

Re-posted 19 days ago

Job description

Overview
We are seeking a detail oriented Physician Advisor to join our inpatient team full time. This role serves as a key clinical and operational leader, supporting effective utilization of healthcare services and ensuring compliance with payer and regulatory requirements. The Physician Advisor provides expertise in medical necessity, documentation, care progression, and denial management, working closely with Care Management, Utilization Review, Revenue Cycle, and hospital leadership. This position reflects rotating weekend call coverage.
Reporting to the Chief Medical Officer the Physician Advisor partners with medical staff leadership, providers, and resource management teams to optimize utilization practices and support organizational goals.
Essential Duties:
  • Make recommendations on level of care including initial level of care, secondary review, and as requested by case management
  • Make recommendations for documentation improvement to ensure the medical record accurately reflects the patient's clinical status, supports the level of care provided, and meets regulatory and payer requirements.
  • Collaborate with providers to identify opportunities for enhanced documentation that clarifies the rationale for services rendered, severity of illness, and care progression, thereby reducing the risk of denials and facilitating appropriate reimbursement.
  • Make recommendations on level of care, including initial level of care, secondary review, and as requested by case management.
  • Make recommendations for documentation improvement to ensure the medical record accurately reflects the patient's clinical status, supports the level of care provided, and meets regulatory and payer requirements.
  • Review for daily level of care recommendations on cases placed in Observation
  • Participate in the denials management process
  • Be a leader in optimizing denial management
  • Perform peer to peer appeals and draft appeal letters for third party denials where appropriate
  • Apply the 2 midnight rule to Medicare reviews
  • Maintain compliance with Medicare rules as it applies to level of care recommendations
  • Stay current on changes in payer rules including CMS rules as it pertains to utilization review
  • Recommend and request additional and more complete medical record documentation from providers to support placement status or medical necessity
  • Understand and use InterQual, MCG and/or other appropriate criteria
  • Apply medical expertise to assist with appropriate billing for services
  • Provide feedback on payer denial patterns where appropriate
  • Aid in supporting Length of Stay (LOS) strategies (avoidable days) and quality goals.
  • Facilitate, mentor, and educate other physicians regarding documentation and payer requirements.
  • Facilitate, mentor, and educate case management on the utilization review process where appropriate
  • Other duties as assigned to support the unit, department, entity, and health system organization
Responsibilities
Required Education/Licensure:
  • MD or DO
  • Possess and maintain an unrestricted medical license in the State of Illinois
Required Experience:
  • Minimum 5 years clinical experience in a hospital setting
  • Possess or develop a solid foundation in the areas of utilization management and hospital operations
Preferred Education/Licensure:
  • Palliative Care Fellowship
  • American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) Health Care Quality and Management (HCQM) certification
  • American College of Physician Advisors certification (ACPA-C)

Location:
Riverside Medical Group
350 N. Wall St. Kankakee, IL
Employee Health Requirements:
Exposure to:
Chemicals: Refer to MSDS Sheets
Video Display Terminals: Average
Blood and Body Fluids: None
TB or Airborne Pathogens: None other than normal hospital environment exposure.
Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Required to communicate during presentations/training, telephone communication, facilitate meetings, communication with providers and other staff.
Vision: Needed to read memos and literature, type correspondence from handwritten material and to coordinate calendars.
Smell: Helpful to note presence of electrical/fire safety.
Hearing: Needed for telephone communication, meetings, alarms and listening to employees/staff.
Touch: Needed to write, computer entry, filing.
Activity/Lifting Requirements
Percentage of time during the normal workday the employee is required to:
Sit: 70%
Twist: 0%
Stand: 10%
Crawl: 0%
Walk: 15%
Kneel: 1%
Lift: 5%
Drive: 0%
Squat: 5%
Climb: 1%
Bend: 5%
Reach above shoulders: 0%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Occasionally
Up to 20 lbs: Occasionally
Up to 35 lbs: Occasionally
Up to 50 lbs:Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 120
Twist: 0
Stand: 30
Crawl: 0
Walk: 5
Kneel: 2
Lift: 1
Drive: 0
Squat: 5
Climb: 0
Bend: 5
Reach above shoulders: 2
Repetitive use of hands (Frequency indicated):
Simple grasp up to 1 lbs. Normal weight: frequent
Pushing & pulling Normal weight: 5lbs frequent
Fine Manipulation: Moving charts, written documentation.
Repetitive use of foot or feet in operating machine control: None
Environmental Factors & Special Hazards
Environmental Factors (Time Spent):
Inside hours: 8
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere: Normal Range
Special Hazards: None
Protective Clothing Required: None
Pay Range
USD $95.38 - USD $141.06 /Hr

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