Utilization Management Coordinator

Job Summary

Managing the authorization process end to end, the full-time remote Utilization Management Coordinator will handle patient eligibility verification, maintain detailed documentation, and act as a liaison between hospital staff and health payers.

Key responsibilities

• Manage the authorization process from initial notification to discharge, ensuring timely follow-up and accurate record-keeping
• Maintain detailed documentation in EMR systems and health payer portals while verifying patient eligibility and benefits
• Track pending authorizations and escalate issues that may lead to delays or denials

Required qualifications

• High School Diploma or equivalent; Associate degree in healthcare administration preferred
• At least 2 years of experience in hospital billing, follow-up, or authorization settings
• Knowledge of managed care contracts and experience with EMR systems, preferably Epic
• Strong understanding of medical terminology and insurance processes
• Experience in customer support or client issue resolution management