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Utilization Review Intake Coordinator Jobs in Ohio

Sevita

Utilization Review Specialist

Akron, OH · On-site

$40K/yr

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... coordination of required service documentation including corresponding billing tickets Tracks ...

lhs

Hospice Nurse Intake Coordinator

Cleveland, OH · On-site

$17.50 - $23.75/hr

Hospice Nurse Intake Coordinator Experience Level: 5+ Years (Required) Position Type: Full-Time ... Review & Screen: Evaluate incoming referrals from hospitals, long-term care facilities, and ...

Nationwide Children's Hospital

$17.50 - $24/hr

Coordinates and assists in the provision of health resources and services to clients. Essential ... Identifies emergent or complex cases and seeks clinical review prior to finalizing the referral.

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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.

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

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

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

Cities in Ohio 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 Ohio as of August 2026, with employment types broken down into 100% Full Time. Highlights an 84% In-person, and 16% Remote job distribution.

Utilization Review Coordinator

Neuropsychiatric Hospitals

Huber Heights, OH

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 14 days ago

Job description

Healing Body and Mind.

NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it’s needed most.

With locations in Indiana, Michigan, Texas, and Arizona, we’re expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day


North Valley Behavioral Hospital, a brand new psychiatric hospital within the NeuroPsychiatric Hospitals network, is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.

Benefits of joining NPH

  • Competitive pay rates
  • Medical, Dental, and Vision Insurance
  • NPH 401(k) plan with up to 4% Company match
  • Employee Assistance Program (EAP) Programs
  • Generous PTO and Time Off Policy
  • Special tuition offers through Capella University
  • Work/life balance with great professional growth opportunities
  • Employee Discounts through LifeMart

  • Filing documents as needed.
  • Initial Precertification with payors.
  • Concurrent Clinical review with payors.
  • Document in the electronic system daily in real time.
  • Admission audit.
  • Ensures that CON’s/RON’s and CMS certifications are completed by provider.
  • Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
  • Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
  • Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
  • Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
  • Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
  • Complies with hospital expectations regarding ethical behavior and standards of conduct.
  • Complies with federal and hospital requirements in the areas of protected health information and patient information.
  • Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
  • Provides education to nursing staff. leadership team, and providers regarding documentation.
  • Actively works with the business office regarding resolution of appeals/denials and retrospective reviews. 

Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.

Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.

Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.

Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW

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