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Utilization Review Technician Jobs (NOW HIRING)

KPC Health

Utilization Review Tech

Santa Ana, CA · On-site

Utilization Review Technician Under direction of the Utilization Review Technician Supervisor, the Utilization Review Technician coordinates with the Utilization Management Department while being ...

KPC Global MSO

Utilization Review Tech

Santa Ana, CA · On-site

SUMMARY Under direction of the Utilization Review Technician Supervisor, the Utilization Review Technician coordinates with the Utilization Management Department while being responsible for ...

Sutter Health

Utilization Review Tech III

San Mateo, CA · On-site

$48.91 - $68.47/hr

Graduate of an accredited Psychiatric Technician Program CERTIFICATION & LICENSURE : * LVN-Licensed ... Critical thinking skills necessary to provide utilization review/discharge planning services ...

Sutter Health

Utilization Review Tech III

San Mateo, CA · On-site

$48.91 - $68.47/hr

Graduate of an accredited Psychiatric Technician Program * CERTIFICATION & LICENSURE : * * LVN ... Critical thinking skills necessary to provide utilization review/discharge planning services ...

Sutter Health

Utilization Review Tech III

San Mateo, CA · On-site

$48.91 - $68.47/hr

Graduate of an accredited Psychiatric Technician Program CERTIFICATION & LICENSURE : * LVN-Licensed ... Critical thinking skills necessary to provide utilization review/discharge planning services ...

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Utilization Review Technician information

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How much do utilization review technician jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for utilization review technician in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a utilization review technician?

A Utilization Review Technician is a healthcare professional who assists in the review of medical records to ensure that patients receive appropriate care while also verifying that such care meets insurance and regulatory standards. They collaborate with nurses, physicians, and insurance companies to assess the necessity and efficiency of medical treatments and services. Their work helps manage healthcare costs and ensures compliance with healthcare policies and regulations. Utilization Review Technicians typically have a background in healthcare or medical coding and must be detail-oriented and familiar with medical terminology.

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

To thrive as a Utilization Review Technician, you need a solid understanding of medical terminology, healthcare regulations, and insurance processes, generally supported by a healthcare-related associate degree or certification. Familiarity with utilization management software, electronic health records (EHRs), and coding systems like ICD-10 and CPT is typically required. Attention to detail, critical thinking, and strong organizational and communication skills help you effectively evaluate medical records and collaborate with healthcare teams. These skills and qualities are crucial for ensuring appropriate care utilization, regulatory compliance, and accurate documentation within healthcare organizations.

What are some common challenges faced by utilization review technicians when coordinating with healthcare providers?

Utilization Review Technicians often encounter challenges such as collecting timely and complete clinical documentation from providers, interpreting complex medical records, and ensuring compliance with insurance requirements. Effective communication and organizational skills are crucial, as technicians must frequently liaise between providers, insurance companies, and patients to clarify information and resolve discrepancies. Staying updated on evolving regulations and payer guidelines is also key to ensuring that reviews are accurate and claims are processed efficiently.

What is the difference between Utilization Review Technician vs Medical Records Technician?

AspectUtilization Review TechnicianMedical Records Technician
CertificationsNone required, but certifications like URAC can be beneficialCertified Medical Records Technician (CMRT) often preferred
Work EnvironmentHealthcare facilities, insurance companies, utilization review departmentsHospitals, clinics, healthcare offices, medical record departments
Job FocusReviewing medical necessity and insurance coverage for patient careManaging, organizing, and coding patient medical records

While both roles work within healthcare settings, Utilization Review Technicians focus on evaluating the necessity of treatments for insurance purposes, whereas Medical Records Technicians handle the organization and management of patient records. Understanding these differences helps job seekers identify the right career path in healthcare administration.

More about Utilization Review Technician jobs

What job categories do people searching Utilization Review Technician jobs look for?

The top searched job categories for Utilization Review Technician jobs are:

Utilization Review Technician jobs near you
Infographic showing various Utilization Review Technician job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Technician

Riverview Regional Medical Center

Gadsden, AL • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 16 days ago

Job description

Overview
Department: Social Work Services
Shifts Available: Days
Employment Type: Full Time
Hours: 8-hour shift - 7:30am to 3:30pm
Location: Riverview Regional Medical Center - Gadsden, AL
We are seeking an Utilization Review Technician II, sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator II. The Utilization Review Technician II supports the utilization review, appeals, and denial management process by coordinating communication and tracking payer-related activity. This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals, and denials. The position also assists with payer audits, Release of Information, discharge coordination, and other departmental needs.
Responsibilities
  • Coordinate phone calls, data entry, and tracking related to authorizations, expedited reviews, appeals, and denials
  • Document and track all communication attempts with insurance providers and health plans
  • Follow up on denials while partnering with Utilization Review, Business Office, and Case Management teams
  • Maintain accurate tracking of government and payer audits, including RAC, MAC, CERT, ADR, QIO, Medicaid, and pre/post-payment reviews
  • Provide support with Release of Information, discharge coordination, and other assigned departmental duties

Qualifications
  • High School Diploma or equivalent
  • Two years of relevant experience
  • Accurate alphabetic, numeric, and/or terminal-digit filing skills
  • Computer data entry with 10-key, with accurate typing speed of 35 wpm
  • Associates Degree or higher, preferred
  • Excel skills. highly preferred
  • Knowledge of terminal digit filing and medical terminology, preferred
  • Knowledge of State and Federal regulatory requirements for medical staff documentation, preferred
  • Completion of a medical terminology course, preferred
  • Background in business and office training, preferred

Here are some of the benefits of working at Prime Healthcare:
  • Health, dental, and vision insurance options
  • Paid vacation, sick time and holidays
  • Bereavement leave, FMLA and other leave options
  • Employer 401K options
  • Tuition reimbursement options
  • Life, disability, and other insurance options
  • Many other amazing benefits

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/
#LI-MP1
Employment Status
Full Time
Shift
Days
Equal Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

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