Utilization Review Coordinator Salary in Las Vegas, Nevada

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Average Salary for Utilization Review Coordinator in Las Vegas, Nevada

The average salary of a(n) Utilization Review Coordinator in Las Vegas, Nevada is $99,429.

The average hourly rate of a(n) Utilization Review Coordinator in Las Vegas, Nevada is $47.80.

The average bonus of a(n) Utilization Review Coordinator in Las Vegas, Nevada is $5,608.00.

Job Description:

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. Less

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... More

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Results for Utilization Review Coordinator in Las Vegas, Nevada

Associate Director of Pre-service Review, RN - Las Vegas, NV - Las Vegas, NV

UnitedHealth Group

This department encompasses a staff of Pre-Service Review RN’s and and Clinical Administrative Coordinators....

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RN Supervisor, Utilization Management - Las Vegas, NV - Las Vegas, NV

UnitedHealth Group

RN, nurse, case manager, utilization management, utilization review, managed care, CCM, CMS, Las Vegas, bachelor's degree, lead, supervisor, Las Vegas, NV,...

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RN Supervisor Preservice Review - Las Vegas, NV - Las Vegas, NV

UnitedHealth Group

In addition, the RN Supervisor will also perform reviews, to include prior auth and concurrent review; Knowledge of utilization review process and prior...

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Clinical Documentation Coordinator - Las Vegas, NV

University Medical Center of Southern Nevada

American Board of Quality Assurance and Utilization Review Physicians (ABQAURP), or; EMPLOYER PAID PENSION PLAN OF 28% OF YOUR ANNUAL SALARY!...

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Associate Director of Pre-service Review, RN - Las Vegas, NV - Las Vegas, NV

OptumCare

This department encompasses a staff of Pre-Service Review RNs and and Clinical Administrative Coordinators. SMA is headquartered in the greater Las Vegas, NV...

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