1. What is Utilization Review? | Nursing away from the Bedside….
  2. Utilization Review Nurse Interview Questions and Answers | Clinical Review Nurse
  3. Is Utilization Review difficult to learn?
  4. Non-bedside nursing: Utilization Review Registered Nurse
  5. How to Get a Job in Utilization Review! | Overview of Brand New Nonclinical Course
  6. VLOG| Day In The Life| Utilization Review Nurse
  7. How to Become a Utilization Reviewer as a PT, PTA, OT, OTA or SLP

What is Utilization Review? | Nursing away from the Bedside….

hey Claires welcome to my channel Court,that is that Claire if you are a new,viewer hey there hey welcome to my,channel if you enjoyed this video please,dont forget to like us a like and,subscribe if you are oldie but a goodie,a returning viewer hey gray hey boy hey,whats good you know if I have on these,blue skirts that is a nurse related,video so today were going to be talking,about utilization review and I talked,about this before in a previous video,called why I left Nursing so you need to,go ahead hit pause if you have not,watched that video if you have not watch,that video check my description box,theyll be a link gonna watch that and,then come on back and it will continue,to that group and if you have seen it,already go ahead and keep on watching we,talked about utilization review in that,video and I just got a lot of questions,concerns and just I felt like it would,be good for me to provide my wealth of,knowledge if you can call it my my world,wealth of knowledge in regards to,utilization review because I know when I,search going into the to this specialty,it wasnt a lot of information so um,yeah if youre interested honey if you,thinking about leaving the bedside I,want to know your options youre just,interested in a specialty you heard,about it didnt really know what that,means or if you just want to be playing,on those hear me and get the nurse team,go ahead and stay tuned get hit like,subscribe okay so there are two sides to,utilization review theres the payer,side which is the insurance and theres,the provider side which is the hospital,and I can only provide you information,or my perspective from the hospital side,because Ive only worked in the hospital,setting as the utilization review,nursery nurse so what is utilization of,you,well youll and ensure view is a subset,of case management and basically what we,do is we review charts for the,appropriate appropriate utilization of,hospital services and this basically,boils down to levels of care inpatient,observation I know if youre doing your,chart checks and youre checking on your,orders like we always talked about you,will see a status order observation and,impatient these are levels of care these,levels of care are important to the hot,because it determines the amount of,money or determines yeah the amount of,funding that comes back in reimbursement,from the payer this is important from,the tech side because it determines how,much money that they have to give to the,hospital so levels of care are very,important especially if your patient,does not have a level of care or the,patient is in then not an appropriate,level care this can result in a denial,of payment or if your result in a lack,of payment or could result in a full,immerse me so this is important because,it is the money of the hospital so,utilization review its like this whole,facet that is behind the scenes its,kind of like having a watch you know,child way back in the day when people,used to buy the watches off the Canal,Street honey then things went last past,like two weeks two months if youre,doing good because the insides wasnt if,I wasnt wasnt good well the same thing,is the jewels honey lets be clear,because I know about watches and stuff,but the inside of the watch isnt good,so thats the same thing with,utilization review we are the background,of the hospital but if we are not,working efficiently and proficiently,then the hospital does not receive the,money that it needs to operate and make,sure that it is providing efficient safe,care because that goes the money goes,back into jobs and quit me and supplies,yada yada yada so um how do we determine,appropriateness appropriate levels of,care well there are two national,regarded guidelines and that is melamine,or it can be called mcg and intercom um,these are nationally renowned like,nationally known and we all kind of use,them as guidelines I say guidelines,because its not definitive sometimes,you have patients that dont meet the,subsets that are provided and these,patients are reviewed you know from a,medical necessity perspective now,depending on your facility medical,necessity can be decided by a physician,if you have a physician advisor or it,can be decided by the nurse using her,clinical judgment this is why a lot of,hospitals have,having a push to hire registered nurses,in this role because second to,physicians we have the highest level of,clinical judgment so to speak no tea no,shade okay so um I know some of you,asked about training well the only way I,know that you can get training,especially with these systems is through,on-the-job training thats how I got,training once I was on the job then I,got more in-depth training from the,actual providers Milliman and Inter qual,and also Ive got questions about,experience so that goes back to the,clinical judgment part thats why they,need nurses for this they need nurses,for utilization review because we use,our clinical judgement when the systems,the medical necessity cannot be defined,through the system the guidelines so if,you dont have much clinical experience,to go on Im not quite sure how much of,a service will you be our good service,or how much of a benefit you will be in,this role but that does not mean that,you cannot do utilization review I just,think it depends on the employer okay a,lot of times utilization review gets,confused with CBI clinical documentation,improvements and um nursing informatics,I look at my little nut shell sorry um,nursing informatics so let me just,explain the little bit that I do know,about these specialties and if you are,CDI nurse or you are nursing informatics,nurse thats actually in practice go,ahead and drop some comments give me,some information because actually I,would like to know more about those,specialties myself but from what I do,know clinical documentation improvement,so utilization review nurses we ensure,that appropriateness for levels of care,so the pace so that we can get the,hospital can get reimbursement clinical,documentation improvement they come in,and they make sure the physicians,documentation allowed aligns with the,billing and coding so that way when its,time to actually submit the information,on the back end to these payers,insurances,there are the documentation lines up in,the coding lines up so thats just,another technical side of things and,like I said thats all I kind of know,about that Im not an expert in that,area however Ive also heard about,nursing informatics and from what I,understand its using nursing to on,integrating technology and in biomedical,equipment to ensure that we are giving,safe patient care along with the,efficiency of nurses charting so they,use a lot of nursing informatics to help,build these systems like your epics and,youre Citrix is the Citrix excuse me,epic and Cerner to ensure and I know,both the system so where my head today,um epic and Cerner to ensure that they,on these EMRs are efficient for nurses,and nurse interaction so thats where,kind of nurse informatics comes into,play okay so more information about,utilization review is that generally,speaking this role is salary okay so,many of you are one of those nurses who,like to get to the game and get your,little twelve twelve hour shifts six,days a week,type thing you like your overtime this,might not be the length for you because,generally speaking they dont really,give over time you may get a bonus shift,or you may get time and a half on your,holidays but as far as I record racking,up the extra days and extra pay this,might not be your ministry sis um and,also shift hours so I work 14-hour,shifts some of my colleagues work five,eight and I even know some utilization,review nurses who do three twelves but,theyre generally in the IDI setting,interactions so if you are a nurse who,absolutely loves patient care and thats,what you want to do you dont want you,know you love your patients as we all do,but you just want to be hands-on all the,time utilization review may not be th

Utilization Review Nurse Interview Questions and Answers | Clinical Review Nurse

hey guys whats up Daniel here and,youre watching the nurse photographer,whats up nurses those following my,journey I started working in a BPO,company as a utilization review nurse so,if youre also interested in working in,a bbo company,um you can use this website the um,indeed Glassdoor,job Street monster and Linkedin by the,way Im not affiliated with those pero,you can see the job listings in those,websites,um also look I have a new mic,um it is the hyperx solocast but Im not,using this right now because I dont,have the right cord to plug it to my,camera so like right now Im using this,shotgun mic by Boya its a vlogging a,mic but right now Im using it for for,this okay so anyway,um before I share tips on how to answer,the interview questions for the,utilization review position case,management case management position,lets talk about the salary first so,usually it will depend on the company,and their clients iOS and if you search,some websites because it would range,around 50 to 70 000 and some would also,go high as 80 000 in basic but always,remember that the higher the basic the,higher the taxes okay and also that 50,to 70 000 range,um,I will talk about more about the salary,and incentives or benefits,videos because I want to focus this,video interview questions so as we all,know that one of the hardest part in,finding a new job is at the interview,okay its the most excruciating part,um there is a um two job interviews,usually,bpos for USR ends I dont know,um accounts,but yeah were going to focus on USR and,jobs and usually it is only the initial,and final interview and some might even,require tests but usually so,um Im here to help you answer those,questions and hopefully job interviews,for these,um BPO USR and jobs by the way what Im,going to share is based from my,experience from applying to different no,BPO companies here in the Philippines,and,um the questions might vary from company,to company,but what Im going to share is the usual,questions that most of them will ask all,right so I dont want to keep you guys,waiting,usually the interviews will be done,through online and phone calls so,usually pack online via Zoom or,Microsoft team depends a company,and then so basically lets start with,the initial interview so initial,interview,um they would usually just ask no,um for your credentials um usrl license,more and PHR and license,and when is the expiration date and also,they are also interested to know what,state you pass your NCLEX because for,example one company is better than,company a will Im only Creator nurses,from New Mexico or Illinois and then if,you apply,Im from Texas and they will um shoulder,the endorsement from Texas to New Mexico,Illinois,shoulder the expenses also they are,interested in knowing the expiration,date because if its expired third they,will shoulder the cost of the renewal of,your license and the CE units so win-win,situations,all right they would also ask for your,um nursing experience,um and also its an advantage if you,have a experience in the BPO company at,least six months but not necessarily,because in the um in the company where,Im working,my experience bbo and then the rest,um some accounts they know I would,prefer like one to two years of bedside,or ER experience or kahit mix mix,language and again Advantage Pokemon bbo,experience if for example you dont meet,the requirements the number of years in,a hospital,they will usually put you or assign you,in accounts that dont need,um bedside experience so thats for the,initial interview and then lets start,with the final interview,okay for the final interview these are,usually the questions that they will ask,okay this one and another more questions,by here,okay so lets um discuss them one by one,so usually,um the first question they will ask you,is tell me something about yourself,um just be yourself no,um also it would help if you,um make a script now to answer this,parallel you dont get caught off guard,no you know what you will say and one of,the advantages of having a online,interview is you can have your um laptop,in front of you and then you can just,read no with feelings,with feelings,so first off now when they ask you first,is,like tell me something about yourself,so like first sir I would like to thank,you for giving me this opportunity to be,interviewed for this nursing position I,finished nursing back in,in school and after a year I was able to,practice nursing in this government,hospital it was a good experience to,establish establish my basic nursing,knowledge and then after a year my,contract expired I worked in a BPO named,for six months and then I studied for,culinary arts or photography,and then,um lets go to the set to the next um,question,approach is tell me something about,yourself that is not included in your,resume so like,um youre gonna answer this as a someone,coming from a suguro family of doctors,or med tech or nurses,[Music],I would like to thank you for giving me,this opportunity to,um be interviewed for this nursing,position,um I came from a family of nurses I,lived with my sister suguro no or,grandmother or parents and I believe,that,um learning does not stop in school that,is why I have a lot of books here in my,room and I kept on reading a lot of,books to improve myself and I also like,to learn new skills from time to time,that is why I learned or enrolled myself,in culinary arts or photography so from,that at least Im giving you an idea,um,just be yourself no,um,and then another question the next,question is why did you leave your last,job no why did you leave your hospital,experience,um,[Music],like I had to take care of my,um Lola or Lolo because my siblings are,already in the states no Im the only,family member here in our house,during that time thats why I was forced,to leave my previous job,and another approach for this question,is um you can say that,um,no parang,you like your job in the hospital but,um I dont think that its safe to,practice nursing,anymore,um,number of patients uh,[Music],dont say those,weeds okay next question,um,why should we hire you or what can you,contribute to us advantages,um just to give you guys an idea,I will be thorough in my Approach and,assessment with the documents that are,files that I will work on,and I am able to follow the I dont know,company rules,rules and regulation of the company,is,a company so from there I think,um,um,as a person so,its just to help you guys give you guys,and at least,no um an idea on how to answer them,um,the next question is,what is your weakness,um,is public speaking so it doesnt matter,if its a group of five or ten people no,I still get uncomfortable and to,overcome this I started a YouTube,channel and a video podcast about,and up to now Im up to now Im still,developing and improving myself in,public speaking skills English,[Music],um,why go back to work in a UR or,BPO company,um,[Music],foreign,[Music],[Music],um,bedside nursing no I you want to explore,you know other fields in the BPO,industry so were gonna know again,[Music],um,okay um next question is how do you,handle stress,hospitals,okay sir I handle stress in a couple of,ways first is I stop whatever Im doing,I pray and then second is I exercise no,because running helps me focus and,prioritize on the things that I need to,finish now or to,um yeah to finish and um lastly,um you can add this no I spend time with,my family I spend time with my friends,or I spend time with my lovely wife,again make a script,with feelings,okay next question is one of the hardest,questions now,um how do you handle a rude supervisor,so for me I think this is one of the,again the hardest questions to answer I,think you will have to research on this,okay,I believe that um or I think that each,of us humans are fighting a battle that,we only know,um and I always think that the per that,person or supervisor might have problems,so I always try to be understanding,um if theres still a problem or a,conflict I would approach I would,app

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Is Utilization Review difficult to learn?

hey whats up guys welcome back to the,nursing Channel so on todays video Im,gonna answer Julie Bonners question and,Julie Bonner is one of my subscribers,who commented the question is,utilization review difficult because she,works in case management and she does,discharge planning and for those who,dont know the case management,department is split into two sections so,you can either do discharge planning or,you can do whats called a utilization,review okay and so shes interested in,jumping over to the utilization review,side of case management and shes asking,is it difficult now the answer to that,question is it is not difficult in,comparison to discharge planning I,personally feel like its easier okay,and utilization review is a good career,choice for those who are looking for a,structured schedule with no surprises,like you know when you do utilization,review you know what to expect the next,day the next day youre not gonna get,any surprises like doing bedside care,where somebody you know happens to get,into cardiac arrest and now you have a,code blue or or in discharge planning,where you know theres lack of,communication and then the patient,discharge becomes delayed for some,reason so utilization review is nice,because you dont really experience any,of those issues youre basically just,going to be looking at patient charts,and reviewing all the progress notes,reviewing the patients vital signs lab,values and the medications that theyre,scheduled on and trying to determine if,there is medical necessity for the,patient to remain in the hospital,thats essentially what a utilization,review nurse does and then once the,utilization review nurse determines that,there,is medical necessity for the patient to,remain in the hospital in a hospital bed,then they communicate that information,over to the patients insurance and,usually what happens is the utilization,review nurse will fax over clinical,information to the insurance and then,also what a utilization review nurse,does is they use and so they a,utilization review nurse determines,whether a patient has medical necessity,to remain in the hospital by using a,tool called inner core and inner qua is,a set of guidelines so that will guide,you in determining whether the patient,should remain in the hospital and so,just to focus on Julie Bonners question,is utilization review difficult no I do,not think it is difficult actually a lot,of people that have gone into the,utilization review department with no,experience say that its it could be,monotonous and tedious but Ive never,heard anybody say that its difficult or,theyre leaving the department because,its hard and they dont understand,usually people just leave the department,because they just feel like its it gets,tedious because youre youre,essentially its basically a desk job,theres very little little patient,interaction youre primarily going to be,talking with like physicians every now,and then just to get orders changed but,other than that I mean youre fixed to,your desk and your computer so if thats,something that youre looking forward to,youre looking for a job that stress,levels are lower then I would recommend,becoming utilization review nurse and,just one I just want to clarify things,just because it is an easier job,this job is still a very important job,because your clinical reviews are,necessary because without them without,you communicating with the patients,insurance the hospital is not going to,get reimbursed for the medical services,that are being provided to the patient,oftentimes when the patients insurance,doesnt receive these clinical reviews,and clinical information theyll act,there they will deny the patients,hospital stay meaning they wont pay the,hospital for the services that were,provided to the patient so anyways this,is just this is just a quick response to,her question I hope this question this,answer helps you guys out like this,video and subscribe to this channel if,you found this video helpful Ill see,you guys later

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Non-bedside nursing: Utilization Review Registered Nurse

hey guys welcome back and if youre new,here welcome consider subscribing if you,find any of this information valuable,and in this video I want to talk about,what I do as a registered nurse so my,current position is a utilization review,registered nurse so if youre interested,in knowing more keep on watching what do,i do as a utilization review registered,nurse so like I said its more the,business side of Nursing,I dont wear scrubs I wear business,casual I work a Monday through Thursday,10 hour shifts holidays off weekends off,its like my own little heaven its like,what I wanted but what I do is in a,nutshell what I do is I follow the care,patients who are being seen by our by,other community providers so for example,if a patient for whatever reason ends up,in another hospital that is not our,hospital then we follow their care so,they have to meet specific criteria in,order for us to pay for their,hospitalization so what we do is we,follow their care and we look at their,plan and everything and we transcribe,all those clinical reviews from the,other facility into our documentation,system so that our providers know what,it is that happened in the other,hospitals so thats one thing that we do,the second thing that we do is that we,if our providers within our facility are,either referring patients out to other,community providers for whatever reason,it could be that either the patient is,requesting it we dont have those,services available or maybe our wait,times are too long and the patient needs,to be seen sooner that would be those,would be instances in which we would,send our patients,to be seen by community providers and of,course there has to be like certain,criteria that they have to meet its not,just any anybody can be set out you know,so thats the second thing that we do,and then the third thing that we do is,we do ambulance claims so that means we,review those claims that the patient,decides to call an ambulance then we,review the case as to why it is that,they called and figure out whether our,facility will be paying that ambulance,bill so thats what we do in a nutshell,theres a lot that we do and ten hours,will never be enough because its its a,lot of uh its a lot of work its,never-ending so dont think that just,because you are not doing direct patient,care that youre gonna be like bored,twiddling your thumbs because thats not,gonna happen youre gonna have to work a,regardless of what department youre at,so so far though I am really enjoying it,cuz its something new its something,completely new and Im still learning as,I go but I just wanted to share a little,bit of what it is that is out there,because you guys if you are not happy at,the bedside please know that there are,other like positions available out there,for registered nurses you dont have to,be stuck or feel like theres nothing,beyond the bedside because there are,positions that are beyond the bedside,you just have to look you have to put,yourself out there apply and just go to,the interviews and hope for the best you,know whatever is meant to be will be so,if youre thinking about leaving the,bedside or just like sometimes like if,if youre thinking of leaving the,nursing and all youve worked in is at,the bedside in a hospital setting you,guys theres other jobs out there look,beyond the bedside and I think itll,help you kind of spark that joy of like,just loving nursing again so thats why,I wanted to,Carolus like what it is that I do and we,dont do direct patient care its all,like telephone calls so yeah I just,wanted to share that with you guys,because there are positions out there,and we dont learn this stuff in nursing,school we dont learn that theres all,these like its like a different world,of Nursing that is out there its not,just a hospital so you guys if you,really want to get out get out go apply,and just do your thing like you can do,it and just put yourself out there Ill,talk to you guys next Sunday if you just,found any valuable information in this,video then subscribe and yeah Im here,every Sunday so Ill see you guys next,Sunday,bye

How to Get a Job in Utilization Review! | Overview of Brand New Nonclinical Course

hi my name is bolt nikki and im a,physical therapist and pre-service,coordinator who does utilization review,full-time and ive just created my first,continuing education course its called,non-clinical utilization review,and the reason why i created it was that,ive known lots of people who have,wanted to get into utilization review,and have struggled to be able to get job,offers so i wanted to create a,systematic approach in how to,find jobs apply for jobs interview,accept job offers and then be able to,thrive in,the new career thats been chosen in,utilization review so i just wanted to,show you how this course,is formatted,ive created six different modules,module one two three four five six the,first one is an introduction to,utilization review that youre able to,find out what it is who hires in,utilization review the different job,titles,that are in utilization review and ive,even included a practice quiz because at,the end im going to have this course,submitted for ceu approval,and,the practice quiz will be able to help,you answer the questions that will be in,the quiz thats needed to get ceus,and then in module 2 i have,understanding cms guidelines i go over,the different guidelines that cms has,and thats really important in knowing,when,youre being interviewed what the,different chapter 1 chapter 7 chapter 8,the different guidelines that are out,there when it comes to utilization,review,and then i also do have,bonus information as to,where to get continued education courses,that are free,that you can utilize in your resume,and try to stand out,amongst the competition,i go over how to apply,for,the utilization review jobs and how to,create a resume different ways to make,sure that youre,able to,let your resume get past the applicant,tracking system going over how to create,a linkedin profile,and then i have,interview tips as well as different,things to,know how to prepare for different,questions that are commonly asked,and then,understanding the job offer we go over,the different things that,you need to look at to see if the job,offer is something that is going to work,for you,and then lastly this is the,module that is still in progress,but its,the different things that you need to,know about setting up a home office,and,how to,know whether or not you need to buy,certain equipment for your home office,and ways to,ease into,switching from being a clinician to,going non-clinical,some of the things that stand out about,this course in my opinion is that it,does have a transcription of every,single teaching,thats done,so if you prefer to read what i say,or you prefer to,listen and read however you learn best,you have those options every single,lesson is transcribed,i do have all the,slides you can download them you just,click download,and youll be able to access,all the slides that i go over,that if you wanted to print it out or,save it however you prefer to do it but,it has,everything that you need as far as,being able to access it outside of the,course or to be able to,quickly,review what was talked about,and then,in those different modules as you can,see theres a lot of different modules,but ive tried to keep the time,pretty short for each video,almost all of these videos in the first,module are less than five minutes,and then depending on the topic,the other modules are,different lengths of time the longest,video that i have is less than 25,minutes,and i think that there are options that,if you wanted to,listen to it at,double speed,you could,increase the speed if you wanted to,there are,lots of good tips and tricks that i,think are not in other courses,and,all of this information,is,the way that i wish i had had it,presented to me instead of spending,hours trying to apply for,different jobs,in utilization review i will have,more updates to go along with the course,to,enhance the course you get lifetime,access so any update that happens to the,course you get it for free because,youve already paid for it so thank you,so much for watching this video and i,hope that youll find the content,valuable

VLOG| Day In The Life| Utilization Review Nurse

good times maybe if we try,to make,[Music],me,[Music],all right yall so im back,yall know new jersey now,um,no more plastic bags,so,sometimes i forget,[Music],good morning good morning welcome back,to the channel,if youre new here please hit that,subscribe button,and if you are a returning subscriber,hey,whats going on all right yall so i am,back,and,oh cant yall see me,can you see me all right,hold on let me pay attention real quick,all right yall i am back and,todays my day off so,where am i going,im going to work,im going to work on my day off,oh my gosh i dont know,[Music],listen its been crazy,everybody catch a covet people getting,sick,short staff,thats why im headed to work,am i mad,i mean not really i just dont feel um,i dont know im headed in because we,have a couple people out people are sick,et cetera et cetera,and i didnt want to do them like that,and leave them empty-handed you know,because thats thats just not me,so im gonna go in for eight hours,ill take a day off later this week,and the reason why like its not,terrible like going in is because,im not bedside like im not doing like,physical,you know labor,its a lot of mental,its a whole lot of mental but id,rather just go in and do what i have to,do help them out,and then leave,so i guess we can make this a,day in the life i guess of a utilization,management,[Music],you cant be replaced,[Music],all right yall so for about the past um,two hours ive been looking at the,er board so here we have um utilization,here,24 hours so we have to look at all of,the er boards so we have four ers that,we actually cover,and we screen the patients to see if,theyre going to meet inpatient or,observation,um,[Music],in the er uh so thats what we do so,ive been doing that for the past two,hours now i am about to head to morning,rounds so on the observation unit we do,rounds we round on each patient to see,if now they can be discharged home,or they need to stay in the hospital a,little longer and they will be flipped,from observation to inpatient,so thats what im about to go do now,[Music],[Music],foreign,all right so,rounds are over,im taking these good old steps let me,get my steps in,um,im not gonna lie i like the weekend,but i dont want to talk to you know,quick but i like the weekends its,its not as like hectic as during the,week its,barely any administration here you know,and youre just like doing your own,thing like the units,are,uh dark the lights are off its just,very quiet,um im not mad at it im not mad at it,[Music],[Music],[Music],all day long,[Music],its not,[Music],i know,[Music],[Music],all right yall so its been,ive been here for four hours,um only,no im lying ive been here for four and,a half hours so only,uh three and a half hours to go,um im not about to eat lunch yet but i,am about to take my wellness shot,this is from have organic immunity boost,listen,cova is still here um a lot of patients,have been well not a lot but its been,an increase in patients coming in with,lycovet,and and i just want to make sure that my,immune system is up to par so right now,yes im about to take this it has ginger,root tumeric root elderberry black,pepper which activates the turmeric oh i,never knew that so thats something new,and,so well say,but this is what its called,oh,oh you can definitely taste that ginger,oh my goodness,oh my goodness,its not its not too bad its just,spicy,all righties but yes never knew that,black pepper activates turmeric,scent when,so this has organic pomegranate juice,organic ginger root juice water oh,somebodys texting me,uh what tiger texted me water turmeric,root juice organic lemon juice,organic elderberry juice concentrate and,organic ground black pepper,all right so let me get back to it they,are requesting,me to review a patient,all right you guys,back in the stairway,so i just came from um afternoon rounds,so we round on the observation unit,twice a day,in the morning we round on the patients,and we see whats the plan for today,hopefully we can get them out before the,day is over,and around two oclock we just have our,second rounds to make sure that the ones,that we anticipated for discharge,um,have left or,will be leaving,and to check up on the new patients,whove been admitted to the observation,unit,so now i am about to update all of my,notes on all the patients right now i,have,eight,so ill do that,um,and then,pretty much watch the er board and wrap,up my day,all right yall so,oh thats loud hold on,all right,so my day is done,complete,banged out those eight hours,and honestly it wasnt too bad,i can not complain thank you jesus i,prayed before i went in there,i said lord please get me through this,day,and just you know allow me to just get,what i need to get done,without any complications,and luckily,well and thankfully,there werent any,um its so nice outside its like 80. i,got this coat on im ready to take this,coat off,its still bright outside so,thats how my day went,went to rounds twice,watched the three er boards,um completed requests,i did a couple of admissions,and um,and thats it,it was pretty good i didnt have to hand,out any moons today,so,i cannot complain about today and its,already over with,so anyways i hope you all enjoyed this,video,um if you have any questions,please leave them down below if youre,not subscribed please subscribe i would,love to have you here,and i thank you all for the support for,the continued support,and i will see you all in the next video

How to Become a Utilization Reviewer as a PT, PTA, OT, OTA or SLP

hello everyone,welcome to the best training you will,have,and find on how to become a utilization,reviewer,my name is dr emma shapiro and im super,excited,to walk you through what is utilization,review,for rehab therapists and assistants how,to,get a job as a utilization reviewer the,salary,the pros and cons and how to find that,job,what to search on indeed and so much,more,so lets get started so the very first,thing we want to cover,is what is a utilization reviewer some,of you may already know this and you can,fast forward a little bit,some of you dont so im going to dive,into that and the day-to-day,roles and sort of what the day-to-day,looks like as a utilization reviewer,because i really want you to know is,this the right,remote healthcare career option for you,okay so as a therapist or assistant,you are going to be reviewing the,document of other healthcare,professionals,namely rehabilitation healthcare,professionals youre going to be,reviewing that documentation,you are going to be looking for is it,medically appropriate,youre going to be looking for,appropriate billing,appropriate documentation evidence-based,protocols making sure,all of that looks appropriate and good,so,then after youre reviewing that if,everything looks appropriate,then you can approve them for,reimbursement,for their treatment session now if you,dont think,things look appropriate then you can,deny them,or you can discuss it with your team,youre not alone in this process you,dont bear,the reimbursement solely on your,shoulders,youre part of a team of physicians,nurses and,other staff to help make sure that the,sort of the patient is looked,comprehensively and made sure that the,treatment session,is looked at comprehensively but thats,sort of your main,duty is is this documentation,appropriate,is the therapist or assistant doing,whats appropriate yes or no,now what does a day in the life of a,utilization reviewer look like,so youll roll out of bed,youll roll out of bed and youre gonna,hop onto your computer,and already prepared for you will be a,list of about 10,charts 10 patient cases and you have,about,a half hour each or thats what our,mentors say they spend is about a half,hour each,on these cases reviewing the,documentation,and then making his decision whether to,approve or deny reimbursement now,there may be some cases where you may,have to call the therapist or the clinic,you may have to speak with your,interdisciplinary team,but thats thats the day in the life so,a lot of it is really computer-based,uh reviewing documentation and maybe,some reading research,making sure that its the right,evidence-based protocol and thats,thats it its pretty streamlined right,so lets dive into,how much you can earn as a utilization,reviewer,so according to salary.com a utilization,reviewer earns between about seventy,thousand to ninety thousand,now we know that thats means and median,so it all can vary,but you are going to be top tip here,youre going to be asked in the,interview,how much do you want to earn now we,typically recommend you say about 75,000 and thats because thats nice safe,in that median where were not going to,scare away the hiring manager,but its a very fair salary but whats,great about utilization reviewer,is that its pretty much aligned in,salary to what we are,getting as clinicians so youre not,going to be,losing um income by going to this remote,alternative career which i think is,great so that goes a little bit into,what you can potentially earn in this,route and whats really nice is this is,full-time nine to five fully employed so,theres no,1099 theres no you know,entrepreneurship or business,you are a full-time remote healthcare,employee which i think is amazing so,thats a little bit about the salary,now lets go into uh the pros and cons,of being,a utilization reviewer and then after,that well dive into finding a job and,all that good stuff so there are some,pros and cons,so i think the most obvious pro is that,the salary is similar if not sometimes,better,than what you currently earn as a,clinician which is great because im,going to tell you,there are very few remote jobs that pay,equal to your clinical salary,so often youll have to take a pay cut,so its really nice,that this is equal if not more salary,so i think thats great i think the,other thing thats a huge pro,is that this is a nine to five job its,a set schedule,well sometimes they do have weekend,workers and sometimes they do have,evening shifts,but its a set schedule you know other,jobs like,travel recruiting which is another great,remote career option,you know you may be having to do,something at nine oclock at night at,eight oclock,all sorts of you know times of the day,this is very much,youre sitting down eight hours boom,done,so i like that consistency of schedule,um the other thing thats great is that,this is remote you can,often work from home about 90 of the,rehab utilization reviewer positions are,remote,so youre able to work from home so i,think those,are well i got one more so we talked,about its remote,pays great its a steady nine to five i,think the other thing,is that you can still use your clinical,skills which is great because,i think its frustrating having to leave,patient care if youre burnt out,and totally abandon your clinical skills,and then i think the other nice thing is,that,you know if youre tired of of the,physical labor this is not physical,and so if you have pain if you have,arthritis if you have,injuries and you cant perform your,duties safely anymore,this is a great transition okay so,now lets dive into the cons i think,probably,the biggest con is that you dont get,the reward,of seeing your patient you know i i get,a lot of reward,from seeing someone go from a wheelchair,to walking,youre not getting that here um but,maybe the pros outweighs the cons you,know youre,home which is great its less stressful,because its just one singular thing you,have to do so thats another pro is that,its just one singular,thing versus wearing all these hats and,so,um but youre not going to quite get,that patient satisfaction,i think another con is that you know,maybe frustrating denying reimbursement,we know as therapists or as assistants,how hard we work,and that its tough to write a perfect,documentation when youre got a busy,clinic,and so i think that can be frustrating,but i do want to say that,of our mentors none have said that,theyve ever been pressured,to approve or deny a patients chart,that its been,solely on them and the team so if youre,fearful of,pressure at least in the companies that,weve had our mentors,come from they have not had that,pressure i cant promise you,that if you go to certain companies that,wont be there,but so far we havent heard that within,our four or five mentors,um but i think that could be a potential,con i think the third con is that,you know its a little sedentary maybe a,little boring and so,it would be nice to have a little spice,of couple patients here and there,um but some of us are introverts or,extroverted introverts so having this,quieter schedule maybe quite nice so i,think thats the pros and cons,um so now lets go into how to find,these positions,and uh who you know oh wait i got one,more im sorry,before we dive into that lets answer,can assistants become utilization,reviewers,and the answer is yes and so can speech,therapists we actually just had,one of our speech therapy students,become a utilization reviewer,and so yes you totally can,do this and i will dive into that,with what companies you can get hired,from,now i do want to say and be fully,transparent here,that it is harder to find a utilization,reviewer job,than it is to find a clinic position and,its just a pure numbers game,you know there are hundreds of thousands,of clinics out there,and thus hundreds of thousands of jobs,the number of,companies using utilization reviewers is,just,fewer thus the jobs are going to be,fewer so,its just a pure fact now the number of,companies hiring assi

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