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Utilization Review Coordinator
$127,590 (USD)/yr
$61.34 (USD)/hr
$7,196 (USD)/yr
The average utilization review coordinator gross salary in Irvine, California is $127,590 or an equivalent hourly rate of $61. This is 12% higher (+$13,425) than the average utilization review coordinator salary in the United States. In addition, they earn an average bonus of $7,196. Salary estimates based on salary survey data collected directly from employers and anonymous employees in Irvine, California. An entry level utilization review coordinator (1-3 years of experience) earns an average salary of $89,302. On the other end, a senior level utilization review coordinator (8+ years of experience) earns an average salary of $158,486.
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This page is a promotion for SalaryExpert’s Assessor Platform and is not intended for professional use.
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ERI’s compensation data are based on salary surveys conducted and researched by ERI. Cost of labor data in the Assessor Series are based on actual housing sales data from commercially available sources, plus rental rates, gasoline prices, consumables, medical care premium costs, property taxes, effective income tax rates, etc.
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Salary Potential
$143,318 (USD)
12 %
Based on our compensation data, the estimated salary potential for Utilization Review Coordinator will increase 12 % over 5 years.
Most Popular Skills for Utilization Review Coordinator
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Education data not available for this job
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City Overview
The cost of living in Irvine, California is 63% more than the average cost of living in the United States. Cost of living is calculated based on accumulating the cost of food, transportation, health services, rent, utilities, taxes, and miscellaneous.
View Cost of Living PageIrvine is the largest city and a master-planned city in central Orange County, California, United States, in the Los Angeles metropolitan area. The Irvine Company started developing the area in the 1960s and the city was formally incorporated on December 28, 1971. The 66-square-mile (170 km2) city had a population of 307,670 at the 2020 census; it is the 63rd most populous city in the United States. A number of corporations, particularly in the technology and semiconductor sectors, have their...
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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.
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Disclaimer
This page is a promotion for SalaryExpert’s Assessor Platform and is not intended for professional use.
Professionals should subscribe to SalaryExpert’s Assessor Platform.
ERI’s compensation data are based on salary surveys conducted and researched by ERI. Cost of labor data in the Assessor Series are based on actual housing sales data from commercially available sources, plus rental rates, gasoline prices, consumables, medical care premium costs, property taxes, effective income tax rates, etc.
Most Popular Skills for Utilization Review Coordinator
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