How to Become an Utilization Review Coordinator
Step 1: Understand the job description and responsibilities of an Utilization Review Coordinator
What does an Utilization Review Coordinator do?
AN Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Being a Utilization Review Coordinator reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Coordinator consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). The Utilization Review Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Utilization Review Coordinator typically requires 4 to 7 years of related experience.
A utilization review coordinator is a medical professional responsible for making sure that processes which occur in medical institutions are compliant with regulations and standards of quality.
In many regions, review coordinators must also go through special training and pass a number of proficiency exams.
Some review coordinator positions require that professionals have training and experience within a more specific field.
An individual who would like to act as a utilization review coordinator in a mental health facility, for example, might be expected to have experience or certification in a field directly related to mental health or social work.
Commonly, a utilization review coordinator tracks the steps of medical processes.
Step 2: Learn best tips to become an Utilization Review Coordinator
Best tips for those who want to become an Utilization Review Coordinator
Here are some tips to become an Utilization Review Coordinator.
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Communicate with attending physician and program managers, and other providers of service, to assure continuity of care, efficiency, and effective transitions between levels of care.
Provide feedback to the attending physician and treatment team members concerning continuing certification of days/services.
Communicate with external reviewers and referral sources.
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Step 3: View best colleges and universities for Utilization Review Coordinator
Best colleges and universities for Utilization Review Coordinator
- Butler University
- Carroll College
- Cooper Union
- High Point University
- Princeton University
- Providence College
Step 4: Think about whether is it worth to be an Utilization Review Coordinator
Is being an Utilization Review Coordinator Worth it?
The QA Coordinator is responsible for facilitating communication between the Quality Assurance Team, the Internal Quality Assurance Committee, Options….
Experience analyzing utilization and/or claim data using InterQual, Milliman or other clinical utilization tools.
Previous experience in appeals and grievance, utilization management, or member services.
Prior utilization management/review experience, and governmental home health agency.
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Step 5: Prepare relevant skills for being an Utilization Review Coordinator
What skills do you need to be an Utilization Review Coordinator?
Management often looks to professional level roles for execution on their visions and goals, as such some specific skills are required. The workload of this role requires knowledge of: Utilization Management. If you highlight these skills during your interview process, you will be more likely to land the job!
Review medical records confirming treatment and length of stay with medical staff and nursing personnel if required.
Complete authorizations/certifications as permitted if clinical review not required.
Candidates for this role must have a good understanding of medical terminologies, and stay tuned with latest developments in the field; they should possess knowledge of reviews such as MAC, KEPRO, and RAC; strong observing skills and the ability to monitor safety plans are also needed.
Obtaining all necessary information required for utilization review processing for internal and external sources per policies and procedures.
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Step 6: View average salary for Utilization Review Coordinator
How much does an Utilization Review Coordinator make?
The average salary range for an Utilization Review Coordinator is from $80,163 to $99,626. The salary will change depending on your location, job level, experience, education, and skills.
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Average salary for Utilization Review Coordinator jobs
Step 7: Find relevant Utilization Review Coordinator jobs, and apply.
Looking for Utilization Review Coordinator jobs?
Here are some Utilization Review Coordinator jobs in the United States.