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Utilization Review Technician Jobs (NOW HIRING)

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-Licensed ... Critical thinking skills necessary to provide utilization review/discharge planning services ...

RSC Healthcare Staffing

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Care Manager - RN - Care Coordination & Utilization Review

Bronx, NY · On-site

$55 - $60/hr

... Utilization review and discharge planning Computer literacy -Five (5) years minimum of clinical ... Technicians All skilled medical and allied health professionals As a leader in the healthcare ...

Prime Healthcare

Utilization Review Nurse LVN

Ontario, CA · On-site

$71K - $99K/yr

Responsible for the daily coordination and oversight to the Referral Technicians with regard to ... Utilization Management experience required. * Excellent interpersonal relationship skills with ...

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Utilization Review Technician information

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How much do utilization review technician jobs pay per hour?

As of Jul 25, 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 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 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 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.

What are the key skills and qualifications needed to thrive as a Utilization Review Technician, and why are they important?

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.
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 July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Specialist

Utilization Review Specialist

West River Health Services

Hettinger, ND • On-site

Full-time

Posted 20 days ago

Job description

Position Summary:
Under the direct supervision of the HIM manager, the UR specialist monitors the utilization of resources, risk management and quality of care for patients in accordance to established guidelines and criteria for designated setting and status. Collection of clinical information necessary to initiate commercial payer authorization. Obtain and maintain appropriate documentation concerning services in accordance to reimbursement agency guidelines.
Excellence in Practice:
  • Performs preadmission review on admissions when required by insurance companies/agencies to comply with policies and procedures.
  • Works in coordination with discharge planner, monitoring medical necessity for admissions and appropriate level of services.
  • May also need to notify physician and patient of authorization denials.
  • Inputs collected data into computer system for insurance communication.
  • Assists with retrospective review of specified charts as required.
  • Obtains extensions in length of stays from insurance companies if needed.
  • Obtains preauthorization and/or precertification of services.
  • Reviews hospital records daily to determine if utilization resources could be served in a better environment, OBS vs INPT.
  • Ability to interact on an interpersonal basis with providers and other staff within the organization.
Essential Job Requirements:
  • Education: Appropriate education level required in accordance with licensure.
  • Experience: Three years of relevant experience with superior communication and interpersonal skills. Minimum one year healthcare or clinical experience required.
  • License Requirements: Licensed Practical Nurse (LPN) license with State Nursing Board and/or possess multistate licensure privileges or a Registered Health Information Technician (RHIT) required. Additional coding certifications also acceptable such as certified coding specialist (CCS), certified coding specialist physician (CCS-P), certified professional coder (CPC) and certified professional coder – hospital (CPC-H).

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