Utilization Review Clerk

Are you looking for a fulfilling career in the healthcare industry? LifePoint Health is seeking a dedicated and detail-oriented Utilization Review Clerk to join our team. As a Utilization Review Clerk, you will play a vital role in ensuring the efficiency and accuracy of our healthcare services. We are seeking a highly organized individual with excellent communication skills and a passion for providing exceptional patient care. If you have a strong attention to detail and a desire to make a positive impact, we want to hear from you!

1. Conduct thorough reviews of patient medical records to ensure accuracy and completeness.
2. Collaborate with healthcare providers to obtain necessary documentation for utilization review.
3. Analyze and evaluate patient records to determine appropriate level of care and treatment.
4. Communicate with insurance companies to obtain authorization for services.
5. Enter and maintain accurate data in electronic medical records system.
6. Monitor and track patient length of stay and treatment plans.
7. Review and approve/disapprove treatment plans based on established guidelines and protocols.
8. Identify and report any potential issues or concerns related to patient care or documentation.
9. Maintain confidentiality and adhere to HIPAA regulations at all times.
10. Participate in team meetings and provide input on process improvement initiatives.
11. Keep abreast of changes in healthcare regulations and policies related to utilization review.
12. Provide exceptional customer service to patients and their families.
13. Collaborate with interdisciplinary team to ensure coordinated and comprehensive care for patients.
14. Assist in training and mentoring new utilization review clerks.
15. Adhere to departmental policies and procedures and ensure compliance with regulatory standards.

According to JobzMall, the average salary range for a Utilization Review Clerk in Raleigh, NC, USA is between $38,000 and $55,000 per year. This may vary depending on factors such as experience, education, and the specific company or organization the clerk is employed by. Some employers may also offer additional benefits such as health insurance and retirement plans.

LifePoint Health is an American company that provides healthcare services in growing regions, rural communities and small towns. It was established in 1999 and is headquartered in Brentwood, Tennessee. It operates 89 hospital campuses in 30 states. The company was included in the Hospital Engagement Network by the Department of Health and Human Services, being the only private organization in the country.