Utilization Management Coordinator

🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

⏱ Part Time

🟢 Junior

🚫👨‍🎓 No degree required

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

HonorHealth

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2013

🏥 Healthcare

📚 Education

Healthcare • Education

HonorHealth is an integrated healthcare organization that offers hospital and outpatient medical services, primary care, urgent care, telehealth (E-Visits), and patient-facing digital tools like MyChart. The organization also operates a research institute, offers academic programs (residencies, fellowships, CME, medical student resources), maintains a foundation and volunteer/community programs, and provides patient resources such as billing, price transparency, and online appointment scheduling. HonorHealth positions itself as a community-focused health system delivering clinical care, education, and research.

📋 Description

• Assist with administration of Utilization Management functions, including workflow organization, communications, information interpretation, tracking follow-up, research, and report creation • Support UM operations and payer communications to obtain admission approvals through clinical review and appeal processes • Support Care Coordination communications with payers through efficient workflow processes • Monitor and process inbound payer faxes, including renaming, uploading approvals, bed days, and denials • Ensure approvals align with current patient class and escalate discrepancies or conflicting payer communications • Document EMR/EPIC authorization, certification, communications, and clinical data appropriately • Collaborate with UM nurses and payers regarding clinical documentation and authorization requirements • Initiate concurrent denial documentation and coordinate physician advisor peer-to-peer reviews • Perform clerical and revenue-optimizing activities, work assigned work queues, and meet productivity standards • Follow up with payers on fax failures, deferred accounts, and additional approved days • Communicate coverage, admission notification, patient-call, and operational issues to appropriate teams or leadership • Perform reports, research, meeting scribe duties, new-hire onboarding, and other assigned duties

🎯 Requirements

• High School Diploma or GED - Required • Associate's Degree - Preferred • 1 year clerical support experience - Required • 1 year administrative support experience in a healthcare field - Preferred • Knowledge of utilization management, case management, medical insurance, medical office, hospital business office, preservices, admitting, registration, billing, or collections workflows • Ability to organize and prioritize workflow and manage assigned work queues • Ability to interpret critical information and track follow-up • Ability to communicate with internal departments, external payers, UM nurses, Care Coordination teams, and leadership • Ability to document appropriately in EMR/EPIC • Ability to handle payer faxes and meet payer clinical documentation requirements