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Weekday Insurance Utilization Review Jobs in California

KPC Health

Utilization Review Tech

Santa Ana, CA · On-site

Utilization Review Technician Under direction of the Utilization Review Technician Supervisor, the ... Reviews treatment plans and status of approvals from insurers. Collects and compiles data as ...

KPC Global MSO

Utilization Review Tech

Santa Ana, CA · On-site

SUMMARY Under direction of the Utilization Review Technician Supervisor, the Utilization Review ... Reviews treatment plans and status of approvals from insurers. Collects and compiles data as ...

Medix

Utilization Review Nurse

Orange, CA · On-site

$38 - $53/hr

Job Summary Our client is seeking a Utilization Review Nurse responsible for managing the complete ... Term Life Insurance Plan. * We will consider for employment all qualified Applicants, including ...

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All JobsWeekday Insurance Utilization Review JobsWeekday Insurance Utilization Review Jobs in California

Weekday Insurance Utilization Review information

What is the difference between Weekday Insurance Utilization Review vs Weekday Claims Processor?

AspectWeekday Insurance Utilization ReviewWeekday Claims Processor
Primary RoleAssessing medical necessity and appropriateness of servicesProcessing and reviewing insurance claims for payment
CredentialsOften requires healthcare or insurance certificationsTypically requires insurance or administrative experience
Work EnvironmentHealthcare settings, insurance companiesInsurance companies, healthcare offices
FocusMedical review and authorizationClaims data entry and verification

Weekday Insurance Utilization Review focuses on evaluating medical necessity, while Weekday Claims Processors handle the administrative processing of insurance claims. Both roles are essential in the insurance industry but serve different functions related to claims management and healthcare authorization.

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

The most popular types of Insurance Utilization Review jobs in California are:

What cities in California are hiring for Weekday Insurance Utilization Review jobs?

Cities in California with the most Weekday Insurance Utilization Review job openings:

Weekday Insurance Utilization Review jobs near you

Utilization Review Liaison

Washington Hospital Healthcare System

Fremont, CA • On-site

$32.35 - $43.63/hr

Other

Posted 5 days ago

Job description

Utilization Review Liaison

Salary Range: $32.35 - $43.63 + applicable differentials

Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for assisting Utilization Review Case Managers. The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information. The UR Liaison will work directly with all Case Management staff, Business Office, Patient Access, and along with the Hospital's Revenue Cycle to ensure quality and efficiency of certain elements of claims processing, denial prevention, and denial management.

Provides office and referral management support services; assists the Utilization Review Team in obtaining medical records, documenting case information in the system, performing data entry into appropriate databases for monitoring and tracking, and following up on phone calls as directed.

Continue to learn about clinical programs, processes, and changes

May also perform office support functions as required

In addition to performing the essential functions listed below, may also be assigned other duties as required.

Washington Hospital Health System does not utilize any form of electronic chatting, such as Google chat for the purposes of interviewing candidates for employment. If you are contacted by any entity or individual attempting to engage you in this format, do not disclose any personal information and contact Washington Hospital Healthcare System.

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