Utilization Management Coordinator

Job Summary

Managing the authorization process from start to finish, the full-time remote Utilization Management Coordinator will handle documentation, verify patient eligibility, and liaise with hospital staff and health payers to ensure timely processing and compliance with healthcare regulations.

Key responsibilities:

• Manage the end-to-end authorization process, including submission and follow-up for determinations
• Maintain detailed documentation in EMR systems and health payer portals
• Act as a liaison between hospital staff and health payers to facilitate information sharing and resolution of issues

Required qualifications:

• High School Diploma or equivalent; Associate degree in healthcare administration preferred
• Two years of experience in a hospital billing, follow-up, or authorization setting
• Knowledge of managed care contracts and medical terminology
• Experience with EMR systems, preferably Epic
• Strong organizational skills and ability to manage multiple tasks in a fast-paced environment