Licensed Utilization Management Coordinator

A company is looking for a Utilization Management Coordinator (Home-Based) - Prior Authorization. Key Responsibilities Monitor resource utilization, risk management, and quality of care in accordance with established guidelines Obtain and maintain documentation for services to ensure compliance with reimbursement agency guidelines Input data into systems for insurance communication and assist with medical records coding as needed Required Qualifications Seven years of relevant experience with a minimum of one year in healthcare or clinical settings Current unencumbered Licensed Practical Nurse (LPN) license or Registered Health Information Technician (RHIT) certification Relevant certifications in coding or pharmacy, such as Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) Experience in healthcare reimbursement, insurance industry, and/or authorization processes is preferred Ability to maintain required department-specific competencies and certifications

Mar 27, 2025 - 19:59

A company is looking for a Utilization Management Coordinator (Home-Based) - Prior Authorization. Key Responsibilities Monitor resource utilization, risk management, and quality of care in accordance with established guidelines Obtain and maintain documentation for services to ensure compliance with reimbursement agency guidelines Input data into systems for insurance communication and assist with medical records coding as needed Required Qualifications Seven years of relevant experience with a minimum of one year in healthcare or clinical settings Current unencumbered Licensed Practical Nurse (LPN) license or Registered Health Information Technician (RHIT) certification Relevant certifications in coding or pharmacy, such as Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) Experience in healthcare reimbursement, insurance industry, and/or authorization processes is preferred Ability to maintain required department-specific competencies and certifications