Discharge & Pre-Auth Case Coordinator

University of Maryland Medical System Corporation; Linthicum (MD); On-site; USD 38,000 - 60,000; Full time

Job summary

The University of Maryland Medical System Corporation is seeking a detail‑oriented non‑clinical specialist to support the Reverse Access Center (RAC) program. You will manage pre‑authorization workflows, input data in the EMR, and coordinate denial/appeal processes for post‑acute care referrals.

Ideal candidates bring 2 years in healthcare, familiarity with EMR systems, and strong mathematical and confidentiality skills to help optimize payer interactions and discharge planning across UMMS

Qualifications

• High school diploma or equivalency.
• 2 years' experience in healthcare, or related field.
• Electronic Medical Record (EMR) and insurance authorization experience preferred.

Responsibilities

• Maintain an up-to-date patient list and inbasket for patients referred to RAC from UMMS member organizations.
• Lead the centralized prior authorization for the PAC admission; coordinate with UMMS case management teams to ensure finalized clinical documents are obtained for insurance review.
• Inputs and updates all pertinent information and data in the EMR.
• Coordinate denial and appeal management for PAC as it effects UMMS, including the peer review process.
• Provide PAC bed availability to care management stakeholders across UMMS.
• Perform other duties as assigned.
• Engage with the UMAC Director of Data Analytics and Technology Innovation to ensure CMA workflows align with data capturing.
• Monitor data dashboards for accuracy and support performance improvement activities based on KPIs.

Skills

Healthcare terminology

Insurance processes

Data entry

EMR systems

Mathematical calculations

Confidentiality

Independence

Prioritization

Communication skills

Microsoft Office

Analytical thinking

Education

High school diploma or equivalency

Tools

EMR software

Microsoft Access

Excel

Job description

The University of Maryland Medical System Corporation is seeking a detail‑oriented non‑clinical specialist to support the Reverse Access Center (RAC) program. You will manage pre‑authorization workflows, input data in the EMR, and coordinate denial/appeal processes for post‑acute care referrals.

Ideal candidates bring 2 years in healthcare, familiarity with EMR systems, and strong mathematical and confidentiality skills to help optimize payer interactions and discharge planning across UMMS