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The graph below is a comparison of salary data for 10 jobs in U.S. National Average, U.S. National Average, as provided by the free SalaryExpert® Salary Report and Salary Calculator. If you are a professional who requires compensation survey data for your work please consult ERI Economic Research Institute's Salary Assessor.

Utilization Review Coordinator:
Analyzes and evaluates patients' medical records, charts, computer printouts, and support documents to ensure criteria for admission to health-care facility, treatment, and length of stay are met, and to ensure cost effective utilization of resources, according to established criteria

Analyzes insurance,... [+] More

Utilization Review Coordinator:
Analyzes and evaluates patients' medical records, charts, computer printouts, and support documents to ensure criteria for admission to health-care facility, treatment, and length of stay are met, and to ensure cost effective utilization of resources, according to established criteria

Analyzes insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients. Reviews admission records, medical records, charts, and supporting documentation to establish reason for admission, diagnosis, and length of stay. Approves admission or refers case to facility utilization review committee for review and course of action when case fails to meet admission standards. Determines necessity, cost effectiveness, and documentation of treatment and care provided, utilizing coding and classification manuals, insurance, governmental, and accrediting agency regulations and standards to determine that established criteria for admission and care have been met. Reviews pre-certification request and application for admission, calculates estimated cost of prescribed medical treatment, prepares required paperwork, and approves admission based on predetermined criteria for pre-hospitalization request from health providers or insurance subscribers. Monitors health care treatment provided to patient during patient's stay in medical facility and compares inpatient medical records to established criteria and confers with medical personnel and other professional staff to determine legitimacy of treatment and length of stay, to ensure services are within prescribed limitations, to ensure availability of future benefits, and to guard against potentially abused medical procedures and diagnoses. Retrieves medical data from medical records, charts, and computer, and abstracts required data from records to use in compiling reports and for statistical purposes. Acts as liaison for insurance provider, contractors, and subscribers to explain and interpret provisions of contractual agreements and health benefits and to process complaints. May assist review committee to plan and conduct federally mandated quality assurance reviews. May direct activities of utilization review staff. May conduct telephone reviews to ensure that patient admission to provider facility meets established criteria. May interview patient to obtain medical history information and determine necessity of treatment. (Source: eDOT Job Description) [-] Less

Greensboro, NC, Miami, FL, Washington, DC, Brooklyn, NY, Denver, CO, San Antonio, TX, Austin, TX, Philadelphia, PA, San Diego, CA, Milwaukee, WI, Tampa, FL, Cincinnati, OH, Indianapolis, IN, Las Vegas, NV, Seattle, WA, Fort Lauderdale, FL, Sacramento, CA, Charlotte, NC, Columbus, OH, Jacksonville, FL, Nashville, TN, Cleveland, OH, Birmingham, AL, Baton Rouge, LA, Pittsburgh, PA

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Utilization Review/Quality Assurance Coordinator, Utilization Review Director, Utilization Review Manager, Utilization Review/Quality Assurance Director, Property Utilization Officer, Real Estate Utilization Officer, Utilization Review Supervisor, Superintendent Labor Utilization, Utilization Supervisor, Medical Claims Review Manager, Medical Claims Review Nurse, Utilization Engineer, Banking Loan Review Analyst, Analyst Loan Review, Loan Review Analyst, Utilization Coordinator, Utilization Management Director, Correspondence Review Clerk, Insurance Review Clerk

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