Utilization Management Coordinator

Job Summary

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

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
• Act as a liaison between hospital staff and health payers to facilitate information sharing and resolve issues that may lead to delays or denials

Required qualifications

• High School Diploma or equivalent; Associate degree in healthcare administration preferred
• Two years of experience in a hospital billing, follow-up, or healthcare setting related to authorization
• Knowledge of managed care contracts and medical terminology
• Experience with EMR systems, preferably Epic
• Proficiency in MS Office and web systems