Utilization Management Coordinator

Job Summary

Managing the authorization process from start to finish, the full-time remote Utilization Management Coordinator will verify patient eligibility and benefits, maintain detailed documentation, and act as a liaison between hospital staff and health payers.

Key responsibilities

• Manage the end-to-end authorization process, including notification, entry, submission, and follow-up
• Maintain comprehensive documentation in EMR systems and health payer portals
• Verify patient eligibility and benefits while tracking pending authorizations for timely responses

Required qualifications

• High School Diploma or equivalent; Associate degree in healthcare administration preferred
• 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
• Proficiency in MS Office and web systems