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Utilization Review Intake Coordinator Jobs in Indiana

Parkview Health

BHI Intake Navigator

Fort Wayne, IN · On-site

$37K - $42K/yr

Reviews referrals and determines patient's eligibility for services based on treatment ... Coordinates authorization of services with the payor and maintains authorization during the patient ...

Abhs

Intake & Assessment Therapist

Indianapolis, IN · On-site

$70 - $80/hr

Intake & Assessment Therapist Full Time Professional 8445 Keystone Crossing #180, Indianapolis, IN ... Responsible for review and acceptance of client Informed Consent documents. * Ensuring all Informed ...

ABHS

Intake & Assessment Therapist

Indianapolis, IN · On-site

$70K - $80K/yr

Responsible for review and acceptance of client Informed Consent documents. * Ensuring all Informed ... Attend weekly Intake Clinical Meeting. * Facilitate referral of clients to higher levels of care ...

Mulhaupts

Scheduling Coordinator

Lafayette, IN · On-site

$17 - $19/hr

As a Service Coordinator, you will be the central hub for our service operations -- managing the ... utilization. * Review work orders daily; ensure all necessary details are captured before ...

Beacon Health System

W/Alt UM Nurse (BHS)

Granger, IN · On-site

Critical utilization management functions during the admission phase include admission review for ... Coordinating with the Manager/Director (and other management as appropriate) to identify and ...

Caregivers

Intake Specialist (LPN)

Indianapolis, IN

$17 - $22.75/hr

Receive, review, and clinically screen referrals from hospitals, physicians, facilities, and ... Intake, admissions, or care coordination experience preferred * Knowledge of Medicare, Medicaid ...

Caregivers

Intake Specialist (LPN)

Indianapolis, IN

$17 - $22.75/hr

Receive, review, and clinically screen referrals from hospitals, physicians, facilities, and ... Intake, admissions, or care coordination experience preferred * Knowledge of Medicare, Medicaid ...

Caregivers

Intake Specialist (LPN)

Indianapolis, IN · On-site

$17 - $22.75/hr

Receive, review, and clinically screen referrals from hospitals, physicians, facilities, and ... Intake, admissions, or care coordination experience preferred * Knowledge of Medicare, Medicaid ...

Caregivers

Intake Specialist (LPN)

Indianapolis, IN

$17 - $22.75/hr

Receive, review, and clinically screen referrals from hospitals, physicians, facilities, and ... Intake, admissions, or care coordination experience preferred * Knowledge of Medicare, Medicaid ...

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All JobsUtilization Review Intake JobsUtilization Review Intake Coordinator JobsUtilization Review Intake Coordinator Jobs in Indiana

Utilization Review Intake Coordinator information

What does a utilization review intake coordinator do?

A Utilization Review Intake Coordinator is responsible for reviewing and processing incoming referrals and requests for healthcare services to ensure they meet clinical guidelines and payer requirements. They collect and verify patient information, coordinate with healthcare providers, and initiate case reviews for medical necessity and insurance authorization. Their work is vital in ensuring patients receive appropriate care while adhering to insurance and regulatory policies.

What are the key skills and qualifications needed to thrive as a utilization review intake coordinator?

To thrive as a Utilization Review Intake Coordinator, you need a solid understanding of medical terminology, insurance processes, and healthcare regulations, often supported by a background in healthcare administration or nursing. Familiarity with electronic medical records (EMR) systems, insurance verification tools, and authorization management software is typically required. Strong organizational skills, attention to detail, and effective communication are essential soft skills for this position. These competencies ensure accurate and timely processing of patient cases, compliance with regulations, and coordination among patients, providers, and payers.

What are some common challenges faced by utilization review intake coordinators, and how can they be managed?

Utilization Review Intake Coordinators often face the challenge of managing high volumes of case referrals while ensuring accuracy and timeliness in processing. Balancing multiple priorities, such as coordinating with clinical staff, verifying insurance information, and meeting regulatory deadlines, can be demanding. Effective time management, strong communication skills, and familiarity with electronic health record (EHR) systems are essential for handling these challenges. Staying organized and building strong working relationships with both internal teams and external stakeholders also helps streamline workflows and reduce stress.

What is the difference between Utilization Review Intake Coordinator vs Utilization Review Nurse?

AspectUtilization Review Intake CoordinatorUtilization Review Nurse
CredentialsHigh school diploma or equivalent; certification may be preferredRN license; certification in case management or utilization review often required
Work EnvironmentOffice setting, administrative tasks, patient data intakeClinical setting, reviewing medical records, patient care coordination
Employer & IndustryInsurance companies, healthcare providers, third-party administratorsHospitals, clinics, insurance companies
Search & Comparison IntentFocus on administrative and intake responsibilitiesFocus on clinical review and patient care decisions

The Utilization Review Intake Coordinator primarily handles administrative tasks related to patient data intake and initial review, often requiring administrative credentials. In contrast, the Utilization Review Nurse performs clinical assessments, reviews medical records, and makes patient care decisions, requiring an RN license. Both roles are essential in healthcare utilization management but differ in their focus and qualifications.

What are popular job titles related to Utilization Review Intake Coordinator jobs in Indiana?

For Utilization Review Intake Coordinator jobs in Indiana, the most frequently searched job titles are:

What job categories do people searching Utilization Review Intake Coordinator jobs in Indiana look for?

The top searched job categories for Utilization Review Intake Coordinator jobs in Indiana are:

What cities in Indiana are hiring for Utilization Review Intake Coordinator jobs?

Cities in Indiana with the most Utilization Review Intake Coordinator job openings:

Utilization Review Intake Coordinator jobs near you
Infographic showing various Utilization Review Intake Coordinator job openings in Indiana as of August 2026, with employment types broken down into 100% Full Time. Highlights an 79% In-person, and 21% Remote job distribution.

Utilization Manage Nurse (BHS)

Beacon Health System

Granger, IN • On-site

Other

Posted 26 days ago

Beacon Health System rating

6.7

Company rating: 6.7 out of 10

Based on 145 frontline employees who took The Breakroom Quiz

534th of 898 rated healthcare providers

Job description

Reports to the Manager. Serves as a liaison between hospitals, physicians, third-party payors and auditors to ensure information needs are met. Responsibilities include the review of medical records to determine the appropriateness and medical necessity of hospitalization. Coordinates and maintains the appeal process for denied hospitalizations. Maintains confidentiality regarding all information collected.
MISSION, VALUES and SERVICE GOALS
  • MISSION: We deliver outstanding care, inspire health, and connect with heart.
  • VALUES: Trust. Respect. Integrity. Compassion.
  • SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Maintains systems for monitoring patient admissions and extended stays for appropriateness and medical necessity by:
  • Reviewing patient admission clinical information using clinical criteria and guidelines available to assist the physician in the determination of medical necessity and/or appropriate admission status (inpatient or outpatient).
  • Communicating, in a timely manner, with third-party payors to justify admission or continued stay.
  • Reviewing extended stays prior to expiration of initially-assigned length of stay.
  • Referring questionable medical necessity or extended stays to the Manager/Director, treating Physician (or Medical Director) as appropriate.
  • Interacting with other Hospital departments in matters related to review decisions and fiscal communications.
  • Facilitating discharge planning by working closely with Nurses and Clinical Social Workers and/or Therapists.
  • These functions apply to associates assigned to Epworth Center only:
  • Maintains system for monitoring and completing Medicare Certification/ Recertification for inpatient psychiatric services.
  • Submission of 1261A forms within 14 days of admission for each Medicaid Psychiatric admission.

Anticipates and reviews denials and facilitates the appeal process by:
  • Anticipating and reviewing denials by payors for lack of medical necessity, inadequate medical information or delay in discharge; also intervening by written appeal to avoid loss of revenue.
  • Arranging physician-to-physician clinical reviews with insurance company, Medical Director and Attending Physician.
  • Writing denial appeal letters on behalf of the patient and/or the Hospital, when appropriate, to avoid loss of revenue.
  • Coordinating with the Manager/Director (and other management as appropriate) to identify and correct weaknesses in the admission and patient care process that can mitigate future denials.
  • Issuing Notices of Non-coverage (insurance &/or Medicare) to patients as necessary.

Serves as a Memorial Hospital and Beacon Health System resource regarding reimbursement by:
  • Maintaining knowledge regarding current regulations (PRO, TJC, AHA, etc.) which impact utilization review activities.
  • Meeting with physicians, Hospital staff, review agencies, insurance companies and others (as relevant) in the assessment of utilization needs.
  • Educating patients and patients' families regarding Medicare regulations and issues, and notices of non-coverage when appropriate.
  • Identifying risk issues concurrently with clinical reviews to provide the Hospital management with valid information on potentially compensable events; also communicating with the Manager/Director and the Director, Risk Management.

Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:
  • Looking for opportunities to improve departmental operations, patient care delivery and utilization of acute healthcare resources; also striving for continuous quality improvement.
  • Staying current on trends related to medical necessity, DRG and Recovery Audit Contractor (RAC).
  • Completing other job-related assignments and special projects as directed.
ORGANIZATIONAL RESPONSIBILITIES
Associate complies with the following organizational requirements:
  • Attends and participates in department meetings and is accountable for all information shared.
  • Completes mandatory education, annual competencies and department specific education within established timeframes.
  • Completes annual employee health requirements within established timeframes.
  • Maintains license/certification, registration in good standing throughout fiscal year.
  • Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
  • Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
  • Adheres to regulatory agency requirements, survey process and compliance.
  • Complies with established organization and department policies.
  • Available to work overtime in addition to working additional or other shifts and schedules when required.

Education and Experience
  • The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a Nursing program. A valid and current Registered Nurse license in the state of Indiana is which the associate works is required. Two years of clinical experience is required. Two years of progressively responsible experience in a utilization review environment is preferred.

Knowledge & Skills
  • Requires fundamental knowledge of the revenue cycle process, which includes such things as patient access, utilization review, charge capture, HIM and patient accounting.
  • Requires the advanced analytical and critical thinking skills necessary to audit patient care data, associated patient care documentation and identify variances in standards of care.
  • Requires knowledge of rules and regulations pertaining to hospital reimbursement.
  • Requires familiarity with managed care principles and an understanding of post-acute continuum of care.
  • Requires the interpersonal skills necessary to maintain effective working relationships and interact effectively with staff, physicians, review agencies, insurance companies, patients and patients' families.
  • Requires the effective communication skills (both verbal and written) necessary to prepare documentation, write appeal letters and to provide education to staff and physicians regarding the revenue cycle process.
  • Demonstrates the ability to be self-motivated, detail oriented and make independent decisions. Also demonstrates the ability to respond quickly and appropriately to customer requests.
  • Demonstrates a working knowledge of the Hospital's computer systems (e.g., Star McKesson, Cerner Power Chart) and proficiency in computer skills (i.e., word processing, spreadsheets, utilizing the internet, etc.).

Working Conditions
  • Works in an office environment and patient care areas when making rounds to review medical records. Will travel between various Beacon facilities.
  • May have contact with patients and family members who may be under considerable stress.
  • May be exposed to bio-hazards.

Physical Demands
  • Requires the physical ability and stamina to perform the essential functions of the position.

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