Utilization Review Technician jobs in Minneapolis, MN
Utilization Review Technician 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 Technician 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 Technician consults with nurses and physicians as needed. Position is non-RN. May require an associate degree or its equivalent. Typically reports to a supervisor. May require Registered Health Information Technician (RHIT). The Utilization Review Technician gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Utilization Review Technician typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Utilization Review Technician jobs
Utilization Review Analyst - Full Time
- NUWAY
-
Saint Paul, MN
FULL_TIME
-
Position OverviewThe Utilization Review Analyst will support the Utilization Review department which acts as a liaison between the clinical treatment team and third-party payers to promote appropriate treatment services, documentation practices and billing integrity for SUD treatment. The Utilization Review Department position ensures system integrity through the treatment continuum from clinical to claims management. Utilization Review Analysts work in a team environment and collaborate with each other to support the department’s responsibilities within NUWAY Alliance as well as other members of the team. This position will also work in conjunction with other departments within the organization to support improvement in the overall quality, completeness and accuracy of medical record documentation.This position allows for a hybrid workplace, utilizing a telecommute work environment. The Utilization Review Analyst must be able to maintain client confidentiality in accordance with state and federal guidelines and HIPAA requirements.Responsibilities
- Audit documentation across NUWAY Alliance programs to substantiate appropriate clinical documentation practices, inclusive of providing data and feedback to staff and leadership about patterns, trends and gap analysis
- Collaboration with Admissions and Clinical teams to identify clients entering treatment programming to determine funding
- Secure funding for client’s admitting into NUWAY Alliance programs and documents approved funding source with approval units and/or dates
- Complete documentation to support extension of funding for programming services, while reviewing medical necessity criteria
- Develop and maintain efficient processes related to client funding, including prior authorizations and concurrent reviews for third party payors
- Facilitate communication with Clinical teams to obtain appropriate clinical documentation to ensure that clinical documentation reflects the level of service rendered to clients is complete, accurate and medically necessary
- Communicate data related to insurance payers, denials and extension requests in a clear and timely manner
- Maintain current information about third party criteria for reimbursement and establish and maintain relations with payers to promote positive and direct communication
- Support all Medical Records Requests from third party payers
- Serve cross-functionally with Clinical teams, Leadership and Billing/Revenue Cycle teams, as well as other internal teams to assist in identification of overpayments
- Support the execution of internal controls to prevent issues with billing, documentation and other processes as applicable
- Maintain positive and open communications NUWAY Alliance staff, departments and leadership
- Conduct oneself in a manner that presents a positive reflection of professionalism, as an asset to the image of the organization
- Other duties as assigned or required
Competencies- Support the Clinical teams with regulation and standard implementation and understanding of the utilization review process
- Utilize clinical knowledge and licensure to support utilization review activities of the organization
- Understand and apply the importance of self-awareness in one’s personal, professional, and cultural life
- Provide services appropriate to the personal and cultural identity and language of the client and other professionals
- Understand the treatment modalities and clinical application to practice at NUWAY to support effective training resources
Qualifications, Skills, Knowledge and ExperienceRequired:- Bachelor’s degree with a major or concentration in a related field
- Current LADC license required
- Age 18 or older
- Clinical documentation integrity, clinical quality improvement, utilization review, discharge planning, or case management experience of at least one year
- At least 1 year of providing Substance Use services in an individual and group counseling setting
- Knowledge of ICD-10 and DSM-5
- Able to pass Minnesota DHS background study
- Must be free of problematic substance use for at least two years immediately preceding employment and must sign a statement attesting to that fact
- High degree of computer literacy including experience using an electronic health records (EHR) system
- Excellent written, communication, customer service, and case management skills
- Ability to relate to people from diverse backgrounds
- Demonstrated working knowledge in the field of substance use disorder and/or mental health, in an addiction treatment facility
- Physical Demands: Sitting for extended periods of time. Daily use of general office and/or residential facility equipment. Lifting (max 25 pounds), minimal reaching, bending and stooping. Ability to effectively navigate program or office environment such as ascending and descending steps, passing through doorways and entrances, and accessing program/office facilities.
Preferred:- Minimum of 1 year experience performing utilization review tasks
- Strong analytical and problem-solving skills
- Strong facilitation, negotiation, investigation and mediation skills
- 14 Days Ago
Document Review
- Ultimate
-
Saint Paul, MN
FULL_TIME
- Job Description Mortgage Document Specialist -Entry Level Positions Pay range: $16.00 hr.Schedule: Monday - Friday 7:30 AM - 4:00 PMLocation: St Paul MN - on site positionHow to Apply: Please apply di...
- 3 Days Ago
Review Coordinator
- MN Adult & Teen Challenge
-
Minneapolis, MN
FULL_TIME
- Job Summary The Review Coordinator will collaborate and partner with the assessment team to assist in the admission and referral process for clients applying to short-term, long-term or outpatient tre...
- 1 Month Ago
Automotive Technician with Kia of Mankato
- Kia Veterans Technician Apprenticeship Program (VTAP)
-
Mankato, MN
FULL_TIME
- Kia Retailers are offering skilled and experienced military Veterans with the opportunity to begin an inspiring career as a Kia Certified Service Technician. To support this Kia Retailer initiative, K...
- 25 Days Ago
Automotive Technician with Luther Kia
- Kia Veterans Technician Apprenticeship Program (VTAP)
-
Inver Grove Heights, MN
FULL_TIME
- Kia Retailers are offering skilled and experienced military Veterans with the opportunity to begin an inspiring career as a Kia Certified Service Technician. To support this Kia Retailer initiative, K...
- 1 Month Ago
Paid Product Tester
- Product Review Jobs
-
Ridgeland, WI
FULL_TIME
- Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
- 3 Days Ago
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0 Utilization Review Technician jobs found in Minneapolis, MN area
Field Service Technical Specialist
- Chart Industries
-
New Prague, MN
- Field Service Technical Specialist **Location:** Work From Home, XX - Home Office, United States, n/a **Company:** Chart...
- 4/27/2024 12:00:00 AM
Press Brake Technical Specialist
- Mate Precision Technologies
-
Anoka, MN
- Who We Are Established in 1962, Mate Precision Technologies is a world-class manufacturer serving the precision fabricat...
- 4/27/2024 12:00:00 AM
IT Technical Specialist I
- Imagine IT
-
Minneapolis, MN
- Can you imagine a career in IT where you enjoy coming to work every day? We can! For over 20 years we've been imagining ...
- 4/26/2024 12:00:00 AM
Program Technical Specialist (SAC Specialist)
- Metropolitan Council
-
Saint Paul, MN
- Salary: See Position Description Location : 390 Robert St. N St. Paul, MN Job Type: Full-Time Job Number: 2024-00123 Div...
- 4/26/2024 12:00:00 AM
Sales Application Engineer - Technical Specialist
- Trane Technologies
-
Minneapolis, MN
- At Trane TechnologiesTM and through our businesses including Trane® and Thermo King®, we create innovative climate solut...
- 4/26/2024 12:00:00 AM
ELECTRONIC SYSTEMS TECHNICAL SPECIALIST - Transfer Switches
- Cummins
-
Minneapolis, MN
- ELECTRONIC SYSTEMS TECHNICAL SPECIALIST - Transfer Switches Description ELECTRONIC SYSTEMS TECHNICAL SPECIALIST - Transf...
- 4/26/2024 12:00:00 AM
Public Assistance Disaster Recovery – Technical Specialist
- AECOM
-
Minneapolis, MN
- **Company Description** **How will you make your mark?** At AECOM, our work in providing access to clean water enables c...
- 4/25/2024 12:00:00 AM
Technical Specialist - Adhesives
- H.B. Fuller Company
-
Saint Paul, MN
- As the largest pureplay adhesives company in the world, H.B. Fuller's (NYSE: FUL) innovative, functional coatings, adhes...
- 4/24/2024 12:00:00 AM
About Minneapolis, Minnesota
Minneapolis (/ˌmɪniˈæpəlɪs/ (listen)) is the county seat of Hennepin County and the larger of the Twin Cities, the 16th-largest metropolitan area in the United States. As of 2017, Minneapolis is the largest city in the state of Minnesota and 45th-largest in the United States, with an estimated population of 422,331. The Twin Cities metropolitan area consists of Minneapolis, its neighbor Saint Paul, and suburbs which altogether contain about 3.6 million people, and is the third-largest economic center in the Midwest.
Minneapolis lies on both banks of the Mississippi River, just north of the riv...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Technician jobs
$66,774 to $93,172
Minneapolis, Minnesota area prices
were up 1.4% from a year ago
were up 1.4% from a year ago
What does a Utilization Review Technician do?
Utilization Review Technician in Winston Salem, NC
When considering cost of living, this places Durham, NC as 3rd out of the 4 largest nearby metros in terms of quality of life for Utilization Review Technicians**.
January 02, 2020
Utilization Review Technician in Fairbanks, AK
Current National Pharmacy Technician Certification (PTCB, ExCPT or NCCT) required.
February 03, 2020
Utilization Review Technician in Little Rock, AR
Based on our compensation data, the estimated salary potential for Utilization Review Technician will increase 16 % over 5 years.
February 07, 2020