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Utilization Review Technician
Company : Prime Healthcare Services
Location : North Las Vegas, NV, 89030
Job Type : Full Time
Date Posted : 6 January 2026
Overview
At North Vista Hospital, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in the United States, North Vista Hospital is actively seeking new members to join its award-winning team!
North Vista Hospital is an accredited 177-bed state-of-the-art hospital located in North Las Vegas, Nevada. North Vista offers comprehensive healthcare services, including mental health care, emergency care, heart care, advanced surgical procedures, diagnostic imaging and help for a broad range of medical conditions. Equipped with advanced medical technology and staffed by a team of highly skilled healthcare professionals, North Vista is committed to providing high-quality care in a friendly hospital environment. The hospital has achieved numerous quality award distinctions including Patient Safety Excellence Award, Bariatric Surgery Excellence Award, Heart Failure recognition and more. For more information, please visit www.northvistahospital.com.
Responsibilities
The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals. Document and track all communication attempts with insurance providers and health plans. Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review tech will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. The Utilization review tech will further support the department needs for Release of Information, discharge coordination or other duties as assigned.
Qualifications
Education and Work Experience
1. High School Diploma or equivalent required.
2. Associates degree or higher preferred.
3. Two years of relevant experience required
4. Accurate alphabetic, numeric, and/or terminal-digit filing skills.
5. Computer data entry with 10-key, with accurate typing speed of 35 wpm required. Excel skills highly preferred.
6. Knowledge of terminal digit filing and medical terminology; preferred.
7. Knowledge of State and Federal regulatory requirements for medical staff documentation; preferred.
8. Completion of a medical terminology course; preferred.
9. Background in business and office training; preferred.
Employment Status
Full TimeShift
DaysEqual Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Fernley, NV
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Frequently asked questions
In North Las Vegas, a Utilization Review Technician coordinates with insurance providers to handle denials by tracking authorizations and appeals meticulously. This role demands strong communication skills to follow up on denials and collaborate with case managers, ensuring timely resolution aligned with local payer requirements.
Utilization Review Technicians excel in data entry accuracy, medical terminology, and regulatory knowledge. Unlike general healthcare assistants, they specialize in managing insurance communications, denial tracking, and audit coordination, which requires precision and familiarity with state and federal medical documentation standards.
Progression often involves obtaining certifications like utilization management or nursing review credentials. Gaining expertise in healthcare regulations and audit processes can lead to roles such as Utilization Review Nurse or Management positions, especially within hospital systems like Prime Healthcare Services.
Prime Healthcare Services values certifications in utilization management and medical terminology. While an associate degree is preferred, certifications related to utilization review nursing or healthcare compliance enhance candidacy for these technician roles, reflecting local healthcare compliance standards.
North Las Vegas sees steady demand for utilization review roles due to its expanding healthcare facilities. Competition involves candidates with strong administrative skills and healthcare knowledge, especially those proficient in audit tracking and insurance communications, making certifications a noteworthy advantage.
Utilization Review Technicians in North Las Vegas typically earn between $45,000 and $55,000 annually, influenced by experience and certifications. This range aligns closely with national averages but may vary slightly due to local cost of living and healthcare market dynamics.
At Prime Healthcare Services, Utilization Review Technicians play a pivotal role in denial management and government audit tracking, liaising directly with varied insurance providers. Their involvement in coordinating release of information and discharge planning sets them apart from similar roles at other institutions.
Employment at Prime Healthcare Services offers exposure to a top-tier hospital environment with advanced tech and multidisciplinary teams. This setting fosters skill development in compliance, audit coordination, and insurance appeal processes, paving the way for upward mobility within healthcare administration.
Daily duties revolve around tracking insurance authorizations, managing appeals, and maintaining audit documentation. Effective data entry and consistent follow-ups with insurers ensure compliance and reimbursement, requiring a blend of administrative precision and healthcare knowledge.
A frequent misunderstanding is that the role is purely clerical. In reality, Utilization Review Technicians engage deeply with insurance policies, regulatory audits, and interdisciplinary coordination, making the position critical for hospital revenue cycle and patient care continuity.