LPN Utilization Management Coordinator

Job Summary

A company is looking for a UM Denials Coordinator to support the Utilization Management function by reviewing denied authorizations and preparing denial correspondence.

Key Responsibilities

• Review denied authorization cases to understand clinical determinations prior to letter creation
• Draft, edit, and format denial letters, ensuring clarity and compliance with regulatory requirements
• Communicate with healthcare staff to clarify determinations and resolve discrepancies before letter release

Required Qualifications

• LPN license required
• Two or more years of experience in Utilization Management or medical necessity appeals
• Proficient in Microsoft Office applications, including Word, Excel, and Outlook
• Ability to adapt quickly to changing business needs and learn new processes
• Previous experience reviewing or writing UM denial letter language preferred