RevCycleJobs / RCM Roles / Utilization Review Coordinator
Utilization Review Coordinator: Role, Salary & Career Path
Utilization review coordinators manage insurance pre-authorizations and concurrent reviews, working closely with clinical and insurance teams to ensure patient care is medically necessary and covered. They're the bridge between clinical delivery and payer authorization — preventing denials before they happen.
💰 Salary Ranges
| Level | Typical Annual Salary |
|---|
| Entry Level | $36K–$48K |
| Mid-Level | $48K–$62K |
| Senior / Lead | $62K–$78K |
| Supervisor / Manager | $78K–$105K |
📅 A Real Workday
Here's what a typical day actually looks like for a utilization review coordinator — not the job description version, the real version.
7:00 AM
Process overnight prior authorization requests. Review each case for clinical necessity criteria, check the payer's guidelines, and submit the auth requests through the portal. Flag any cases where the clinical documentation is thin — those need a note to the ordering physician before the payer touches them.
8:30 AM
Coordinate with nursing on three patients requiring concurrent review today. Pull the clinical notes, confirm the continued stay criteria still meet medical necessity, and submit the concurrent review documentation to the payer. One case is borderline — escalate to the UR nurse for clinical review before submitting.
10:00 AM
Contact payers for pending authorization approvals. Two prior auths submitted three days ago haven't been responded to — call the payer's provider line, reference the case numbers, and request expedited review. One payer wants additional documentation; pull the clinical record and upload it through the portal.
11:30 AM
Manage concurrent reviews for inpatient cases. Review the criteria against each patient's current clinical status. One patient has met the discharge threshold but the care team hasn't signed off yet — document the conversation with the attending and set a next-review date to protect the authorization window.
1:30 PM
Update the authorization tracking system. Log approval numbers, denial codes, and follow-up dates for every case worked today. Flag a prior auth that was denied for "not medically necessary" — pull the InterQual criteria, compare to the clinical notes, and initiate a peer-to-peer review request with the payer's medical director.
4:00 PM
Resolve payer denials from this week's batch. Two cases were denied for missing auth — research whether the admissions desk missed the pre-cert step or if the payer's records don't show the authorization that was obtained. Document the finding and route to the appropriate team for correction or appeal.
🛠 Common Tools
Availity
Cohealth
Rhyme
Epic
Cerner
Payer Portals
Excel
📈 Career Path
1
Utilization Review Coordinator
Entry level — 0–2 yrs
2
Senior UR Coordinator
2–4 yrs
4
Director of Case Management
7+ yrs
🎓 Key Certifications
CRCR — Certified Revenue Cycle Representative
HFMA's foundational revenue cycle credential. Validates knowledge of payer authorization processes, denial management, and revenue cycle workflows — directly applicable to UR coordinator roles.
RN Licensure / Nursing Experience
Many UR coordinator roles — particularly concurrent review positions — prefer or require nursing credentials. Clinical background enables coordinators to evaluate medical necessity criteria more effectively and communicate with attending physicians.
CCM — Certified Case Manager
Optional credential from the Commission for Case Manager Certification (CCMC). Valuable for UR coordinators who work closely with case management teams or are targeting senior UR or case management leadership roles.
Browse Open UR Coordinator Jobs
Utilization review coordinator roles updated daily from hospitals, health systems, and payer organizations across the country.
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