UR COORDINATOR (RN OR MSW)
UHS•Hopkinsville, KY
•Onsite
About The Position
The Utilization Review Coordinator is responsible for evaluating and coordinating patient care services to ensure medical necessity, appropriate level of care, and compliance with insurance and regulatory requirements. This role works closely with clinical staff, physicians, and insurance providers to obtain authorizations, support reimbursement, minimize denials, and promote efficient utilization of hospital resources while maintaining quality patient care.
Requirements
- Masters prepared in Social Work or Licensed Registered Nurse
- Two years psychiatric experience with knowledge of psychotropic medications.
- Current nursing license to practice in Kentucky or master’s degree in social work
Responsibilities
- Review admissions and continued stays for medical necessity.
- Obtain and maintain insurance authorizations and approvals.
- Communicate with payers regarding clinical information and coverage.
- Monitor authorization status and help prevent reimbursement denials.
- Coordinate with treatment teams on level-of-care decisions.
- Maintain accurate utilization review and authorization records.
- Assist with denial management, appeals, and peer reviews.
- Ensure compliance with payer, regulatory, and hospital requirements.
Benefits
- Challenging and rewarding work environment
- Competitive Compensation and Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(k) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
- Retention Bonus Program
- Career development opportunities within UHS and its 300+ Subsidiaries!
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
