Senior Utilization Review Specialist

A company is looking for a Senior Utilization Review Specialist focused on Single Case Agreements and Out-of-Network coverage. Key Responsibilities Serve as the primary patient advocate with insurance Lead initial reviews with out-of-network insurance companies for pre-certification Manage appeals and maintain strong relationships with case managers Required Qualifications Bachelor's Degree or relevant experience Previous healthcare or insurance experience required Proven ability to collaborate across teams and departments Organized and detail-oriented Ability to relay detailed patient information in a compassionate and confidential manner

Jun 5, 2025 - 00:30

A company is looking for a Senior Utilization Review Specialist focused on Single Case Agreements and Out-of-Network coverage. Key Responsibilities Serve as the primary patient advocate with insurance Lead initial reviews with out-of-network insurance companies for pre-certification Manage appeals and maintain strong relationships with case managers Required Qualifications Bachelor's Degree or relevant experience Previous healthcare or insurance experience required Proven ability to collaborate across teams and departments Organized and detail-oriented Ability to relay detailed patient information in a compassionate and confidential manner