Top 72 Utilization review coordinator Jobs in Florida

MDS Coordinator- PT
Napes Health and Rehab Center —Naples, FL
- Part-time
- Background check
- Anatomy knowledge
- Skilled nursing facility
Quick Apply
MDS Coordinator
Indigo Manor Nursing and Rehab —Daytona Beach, FL
- $75,000 - $95,000 a year
- Full-time
- Skilled nursing facility
- RN License
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
RN MDS COORDINATOR
Harbourwood Post-Acute and Rehab —Clearwater, FL
- Weekends as needed
- Nursing
- Skilled nursing facility
- RN License
- COVID-19 protective measures
- Health insurance
Quick Apply
MDS Coordinator
THE OAKS OF CLEARWATER —Clearwater, FL
- From $75,000 an hour
- Full-time
- RN License
- Medical office experience
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
3d
MDS Coordinator
Solaris HealthCare Coconut Creek —Coral Springs, FL
- Full-time
- Background check
- CPR Certification
- Skilled nursing facility
- Disability insurance
- Health insurance
Quick Apply
MDS Coordinator RN
Heritage Park Health Center by Harborview —Bradenton, FL
- Full-time
- RN License
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Clinical Denials Coordinator RN, Clinical Denial Unit, Full Time, Days
Jackson Health —Miami, FL
- Full-time
- Hybrid work
- Nursing
- RN License
- Mid-level
Quick Apply
2d
Clinical Denials Coordinator RN, Clinical Denial Unit, Per Diem, Days
Jackson Health —Miami, FL
- Monday to Friday
- Hybrid work
- Nursing
- RN License
- Mid-level
Quick Apply
2d
Care Coordinator, SW I
Bayfront Health —Saint Petersburg, FL
- Full-time
- Hospital
- Mid-level
- Bachelor's degree
- Health insurance
- Benefits from day one
Care Coordinator, SW I
Orlando Health —Saint Petersburg, FL
- Full-time
- Hospital
- Mid-level
- Bachelor's degree
- Health insurance
- Benefits from day one
Utilization Review Coordinator
NRG MGMT LLC —Boca Raton, FL
- Addiction Medicine
- Computer literacy
- Licensed Clinical Social Worker
- Paid holidays
- Dental insurance
13d
Utilization Review Coordinator
PORT ST LUCIE HOSPITAL —Port Saint Lucie, FL
- Full-time
- Background check
- CPR Certification
- Nursing
- Health insurance
- Dental insurance
Quick Apply
Care Coordinator, SW I
Florida Medical Clinic —Saint Petersburg, FL
- Full-time
- Hospital
- Mid-level
- Bachelor's degree
- Health insurance
- Benefits from day one
Care Coordinator-SBHE
Family Partnerships of Central Florida —Maitland, FL
- Mid-level
- High school diploma or GED
- Driver's License
Quick Apply
10d
CREDENTIALING COORDINATOR
Moffitt Cancer Center —Tampa, FL
- $20.64 - $31.47 an hour
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Research
6d
RN Care Coordinator
US Veterans Health Administration —Gainesville, FL
- $60,042 - $133,123 a year
- Online Application
- Background check
- Nursing
- Current TB test
- Paid holidays
- Dental insurance
9d
Care Management Discharge Plan Coordinator, Case Management
Baptist Hospital of Miami —Miami, FL
- $18.87 - $23.96 an hour
- Microsoft Word
- Data analysis skills
- English
- Wellness program
- Health insurance
Denial & Appeals Coordinator- Onsite Coral Gables, Florida
Kindred Hospital South Florida - Coral Gables —Coral Gables, FL
- Hospital
- English
- Mid-level
Registered RN Care Coordinator - Orlando Health Cancer Institute
Orlando Health —Orlando, FL
- Full-time
- Nursing
- RN License
- Bachelor of Science
- Health insurance
- Benefits from day one
1d
Case Management Coordinator (Certified Medical Assistant) | Care Transitions & Chronic Care
Sanitas Medical Center —Boynton Beach, FL
- Full-time
- Spanish
- CPR Certification
- BLS Certification
Quick Apply

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MDS Coordinator- PT

Napes Health and Rehab Center
Naples, FL

Quick Apply

Job Details

Part-time

Qualifications

Anatomy knowledge
Teamwork
Skilled nursing facility experience
Medicare
Utilization review
Medical office experience
Regulatory compliance
Coding for hospital billing
HIPAA
Outpatient experience
Outpatient facility experience
Medical coding experience in outpatient clinics
Acute care facility experience
Clinical data entry
Medicare regulations
Electronic health record (EHR) management for billing and coding
Utilization management
Resource utilization in healthcare
Health information regulatory compliance
Document review
Organizational skills
Centers for Medicare & Medicaid Services (CMS) billing regulations
Clinical documentation improvement
LPN
Home health
Health information management
Clinical confidentiality policies
Clinical documentation standards
Managing patient records
Home health agency experience

Full Job Description

Job Summary
We are seeking a dedicated and detail-oriented MDS Coordinator to join our healthcare team. In this vital role, you will lead the comprehensive assessment and documentation of patient care needs within skilled nursing, rehabilitation, or long-term care settings. Your expertise will ensure accurate completion of Minimum Data Set (MDS) assessments, facilitating optimal care planning, regulatory compliance, and reimbursement processes. This position offers an exciting opportunity to contribute to quality patient outcomes while working within a dynamic healthcare environment that values innovation and teamwork.

Responsibilities

Conduct thorough MDS assessments in accordance with CMS (Centers for Medicare & Medicaid Services) guidelines, ensuring timely completion for each patient.
Collaborate with interdisciplinary teams including nursing, therapy, social work, and medical staff to gather comprehensive clinical information.
Review medical records, clinical documentation, and care plans to accurately code diagnoses and treatments using ICD-10/ICD-9 coding standards.
Ensure compliance with federal regulations such as HIPAA and NCQA standards related to clinical documentation improvement and health information management.
Coordinate with case management and discharge planning teams to facilitate seamless transitions of care for patients across inpatient, outpatient, hospice, or home care settings.
Utilize EMR (Electronic Medical Record) systems like Epic, Cerner, Athenahealth, or eClinicalWorks to document assessments and maintain accurate medical records.
Stay current with updates in healthcare regulations, coding practices including CPT (Current Procedural Terminology), DRG (Diagnosis-Related Group), and utilization review protocols to optimize reimbursement strategies.

Requirements

Proven experience with MDS coordination in skilled nursing facilities, hospitals—including Level I Trauma Centers or Level II Trauma Centers—and outpatient clinics.
Strong knowledge of ICD-10/ICD-9/ICD coding systems, CPT coding, Medicare regulations, and utilization management principles.
Familiarity with EMR/EHR systems such as Epic, Cerner, Athenahealth, or eClinicalWorks is essential.
Background in nursing or medical office administration with critical care experience preferred; ICU or PICU experience is highly advantageous.
Excellent understanding of physiology, anatomy, medical terminology, and clinical documentation improvement practices.
Ability to interpret complex medical records and ensure compliance with HIPAA standards for patient privacy and confidentiality.
Experience working within managed care environments or hospital settings that require acute care expertise; home care or hospice experience is a plus.
Strong organizational skills with the ability to manage multiple assessments efficiently while maintaining attention to detail. Join us as an MDS Coordinator if you’re passionate about enhancing patient care through precise documentation and collaborative teamwork! We value your expertise in medical coding, clinical documentation improvement, and healthcare management—help us deliver exceptional outcomes every day!

Florida Background Screening Requirement:
This position requires a Level 2 background screening through the Florida Agency for Health Care Administration (AHCA) Clearinghouse in accordance with Florida law. Employment is contingent upon successful completion of all required background screening.

For additional information regarding Florida background screening requirements and the Clearinghouse, please visit:
https://info.flclearinghouse.com/

Experience:

MDS: 1 year (Required)

License/Certification:

LPN (Required)

Ability to Commute:

Naples, FL 34103 (Required)

Ability to Relocate:

Naples, FL 34103: Relocate before starting work (Required)

Work Location: In person

Quick Apply

Refine Your Search

utilization review coordinator jobs in florida

MDS Coordinator- PT

MDS Coordinator

RN MDS COORDINATOR

MDS Coordinator

MDS Coordinator

MDS Coordinator RN

Clinical Denials Coordinator RN, Clinical Denial Unit, Full Time, Days

Clinical Denials Coordinator RN, Clinical Denial Unit, Per Diem, Days

Care Coordinator, SW I

Care Coordinator, SW I

Utilization Review Coordinator

Utilization Review Coordinator

Care Coordinator, SW I

Care Coordinator-SBHE

CREDENTIALING COORDINATOR

RN Care Coordinator

Care Management Discharge Plan Coordinator, Case Management

Denial & Appeals Coordinator- Onsite Coral Gables, Florida

Registered RN Care Coordinator - Orlando Health Cancer Institute

Case Management Coordinator (Certified Medical Assistant) | Care Transitions & Chronic Care

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