Bilingual UM Authorization Analyst II

Job Summary

Working remotely on an Eastern time schedule, the full-time Bilingual UM Authorization Analyst II will ensure timely and accurate processing of medical procedure authorizations, review requests, maintain compliance, and coordinate with healthcare providers and insurance companies to support patient care.

Key responsibilities

• Leading daily huddles with UM Physician Reviewers to address risks related to decision-making and documentation accuracy
• Managing denial and appeal escalations while communicating delays to the Director, Utilization Management Compliance
• Preparing and presenting regular reports on authorization activities, including volume and turnaround times

Required qualifications

• Associate's degree in health information management or a healthcare-related field; Bachelor's preferred
• 4-6 years of experience in utilization management
• Bilingual in English and Spanish required
• In-depth knowledge of medical procedure authorization processes and healthcare insurance requirements
• Strong understanding of prior authorization regulatory requirements and turnaround time expectations