Utilization Review Coordinator resume examples for 2025
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Utilization Review Coordinator Resume
Kathleen Cox Utilization Review Coordinator 19964 N. Elm Ave., Charlotte, NC | (710) 555-4299 | kcox@example.com Work Experience Utilization Review Coordinator, CMC Motocross - Charlotte, NC 2019 Functioned as a case manager and utilization review specialist for the high risk obstetrics program. Coordinate patient care with case managers and vendors. Correspond with multiple physician offices and hospitals nation wide for utilization review. Performed admission, stay, and retrospective utilization review using Cerner (EMR). Utilization Review Coordinator, Time Warner Cable Enterprises - Charlotte, NC 2018 - 2019 Perform drug utilization review, medication therapy management, and drug formulary. Directed faxes that did not belong to Utilization Review to the proper office for processing. Review patient medical records for established criteria, and provide a performance report for managerial/physician review. Communication Service Technician, Time Warner Cable Enterprises - Charlotte, NC 2011 - 2018 Time Warner * Responsible for the troubleshooting and repair of cable television and internet services. Analyze service calls and problem solve to determine course of action to be taken. Completed service calls to troubleshoot all equipment at the node level to ensure satisfactory ranges on communication levels. Monitor and record system leakage and repair drop leakage using assigned test equipment. Installed cable television cables and equipment on customers' premises, using electrician's tools and test equipment. Skills Education Associate's Degree Nursing 2009 - 2011 South University - Savannah, GA |
How to write a utilization review coordinator resume
Craft a resume summary statement
Put a resume summary on the top of your resume to highlight your accomplishments. A resume summary sums up your experience and skills, making it easy for hiring managers to understand your qualifications at a glance. Here are some tips to write a strong, impressive resume summary:
Step 1: Mention your current job title or the role you're pursuing.
Step 2: Include your years of experience in utilization review coordinator-related roles. Consider adding relevant company and industry experience as relevant to the job listing.
Step 3: Highlight your greatest accomplishments. Here is your chance to make sure your biggest wins aren't buried in your resume.
Step 4: Again, keep it short. Your goal is to summarize your experience and highlight your accomplishments, not write a paragraph.
These tips will help you demonstrate why you are the perfect fit for the utilization review coordinator position.Hi, I'm Zippi, your job search robot. Let me write a first draft of your summary statement.
List the right project manager skills
Use your Skills section to show you have the knowledge and technical ability to do the job. Here is how to make the most of your skills section and make sure you have the right keywords:
- Look to the job listing. You often need to include the exact keywords from the job description. Take note of the skills listed for the job.
- Put all relevant hard and soft skills in your skills section.
- Be specific. If you are too broad, you may not be giving the best picture of your skills and leave the hiring manager uncertain of your abilities.
- Be up to date. Software names change and companies merge. Don't look out of touch by being careless.
- Be accurate. Spelling and even upper or lowercase can dramatically change meanings. Make sure you are correctly listing your skills.
Here are example skills to include in your “Area of Expertise” on a utilization review coordinator resume:
- Patients
- Patient Care
- Acute Care
- Utilization Management
- Discharge Planning
- Social Work
- Mental Health
- Home Health
- Medicaid
- Utilization Review
- Appeals
- Concurrent Review
- Substance Abuse
- Data Entry
- Outpatient Services
- Peer Review
- Rehabilitation
- Clinical Data
- Review Process
- Clinical Documentation
- CPT
- Medical Services
- CMS
- HIPAA
- Medical Necessity Criteria
- SNF
- Patient Charts
- Federal Regulations
- Hospital Admissions
- Chart Review
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How to structure your work experience
A work experience section is a vital part of your resume because it shows you have the experience to succeed in your next job.
- Put your most recent experience first. Prospective employers care about your most recent accomplishments the most.
- Put the job title, company name, city, and state on the left. Align dates in month and year format on the right-hand side.
- Include only recent, relevant jobs. This means if you're a fairly experienced worker, you might need to leave off that first internship or other positions in favor of highlighting more pertinent positions.
How to write utilization review coordinator experience bullet points
Your resume is not a list of responsibilities or a job description. Instead, it is your chance to show your accomplishments and show why you're good at what you do.
- Use the What, How, and Why format. Answering these questions turns a bland job description into an effective showcase of your abilities.
- What were your responsibilities or goals?
- How did you accomplish them?
- Why were your results important? (How did it impact your company? Can you quantify the results in numbers? )
Here are effective examples from utilization review coordinator resumes:
Work History Example #1
Clinical Social Worker
Bronx Lebanon Hospital Center
- Assisted in positive screen outreach and follow-up.
- Supervised clinical LCSW and LICSW staff.
- Conducted specialty Trauma Group sessions for men and women.
- Worked consistently with high risk families with ongoing domestic violence issues, drug use, criminal activity, and overall trauma.
- Provided resources on various diagnoses, food stamps, housing, legal assistance, IEP planning and advocacy, and parenting.
Work History Example #2
Utilization Review Coordinator
Roberts Home Medical
- Established a culture of performance based benchmarking in a 500 person facility.
- Performed monthly QA audits of medical record to ensure internal compliance.
- Assisted patients with finding a doctor, home health agency, nursing home facilities, and hospice facilities.
- Formulated HMO Prescreening (Precert Plus) program for membership of 68,000 which entailed nurse, patient and physician interview processes.
- Reviewed and coordinated clinical utilization payer expectations for each patient admission where external payment options existed.
Work History Example #3
Community Health Nurse
Medical
- Managed cardiac monitoring for patients who required telemetry.
- Performed health assessments and metabolic syndrome screening, patient education utilizing EMR.
- Communicated via letter and phone with parents regarding care plans, medications, student injury, and possible communicable disease outbreak.
- Coordinated care with PT, OT, ST and HHA services as needed.
- Provided nursing care to pediatric patients in various hospitals on the Pediatric floor, Pediatric step-down unit or Pediatric ICU.
Work History Example #4
Utilization Coordinator
Concentra
- Experienced with Tricare, private insurance companies, and workers compensation for authorization of evaluation and treatment services.
- Confirmed eligibility and verification of insurance benefits for patients with Medicare, Medicaid, and commercial insurance.
- Surpassed cultural and regional obstacles to provide emergency medical and security assistance to expatriates and business travelers via phone and Internet.
- Verified all ICD-9 codes and processed Qualis portals.
- Researched/recommended alternative items to contracts.
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Add an education section to your resume
The education section should display your highest degree first.
Place your education section appropriately on your resume. If you graduated over 5 years ago, this section should be at the bottom of your resume. If you just graduated and lack relevant work experience, the education section should go to the top.
If you have a bachelor's or master's degree, do not list your high school education. If your graduation year is more than 15-20 years ago, it's better not to include dates in this section.
Here are some examples of good education entries for resumes:
Associate's Degree In Nursing
South University, Savannah, GA
2009 - 2011
Highlight your utilization review coordinator certifications on your resume
If you have any additional certifications, add them to the certification section.
Include the full name of the certification, along with the name of the issuing organization and date of obtainment.
Here are some of the best certifications to have on utilization review coordinator resumes:
- Registered Health Information Technician (RHIT)
- Managed Healthcare Professional (MHP)
- Certified Medical Office Manager (CMOM)
- Certified Medical Administrative Assistant (CMAA)