Utilization Management Coordinator

Job Summary

Working remotely in a full-time capacity, the Utilization Management Coordinator will assist in the administration of Utilization Management functions, including workflow organization, communication with payers, and tracking approvals for admissions while ensuring compliance with departmental standards.

Key responsibilities

• Manage inbound faxes from payers, ensuring timely handling and compliance with payer requirements
• Collaborate with UM nurses and internal teams to secure appropriate authorizations for admissions and resolve account discrepancies
• Document and track utilization management clinical requests and facilitate peer-to-peer reviews with payers as needed

Required qualifications

• High School Diploma or GED is required; Associate's degree preferred
• Minimum of 1 year of clerical support experience is required
• 1 year of administrative support experience in a healthcare field is preferred