Utilization Review Coordinator

We are seeking a dedicated and knowledgeable Utilization Review Coordinator to join our healthcare team. This role is crucial in ensuring that patients receive appropriate care while maintaining compliance with healthcare regulations and standards. The Utilization Review Coordinator will assess patient care plans, review medical records, and collaborate with healthcare providers and nurses to optimize patient outcomes.

Responsibilities

Conduct thorough reviews of patient medical records to ensure compliance with established guidelines and protocols.

Collaborate with physicians, nursing staff, and other healthcare professionals to develop effective plans.

Utilize knowledge of medical coding and DRG (Diagnosis-Related Group) systems to support accurate billing and reimbursement processes.

Maintain up-to-date knowledge of medical terminology, anatomy, and emergency medicine practices relevant to patient care.

Provide education and administrative support to patients and families regarding care plans, treatment options, and available resources.

Working hours: 8:00 AM - 5:00 PM

Skills

Knowledge in; CPT , ICD-10, HMO, and PPO

Education

High School

Experience

1-4 years

Qualifications

Excellent communication skills for collaborating with multidisciplinary teams and educating patients about their care plans.

Apply today and become part of something special!

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including health, and an incentive and recognition program (all benefits are based on eligibility).