Healthcare Utilization & Authorization Specialist

Trinity Health; United States; On-site; USD 32,000 - 47,000; Part time

Benefits offered by this job

Comprehensive benefits

Onsite fitness center

Tuition reimbursement

Daily pay option

Job summary

Trinity Health Mid-Atlantic is seeking a part-time Insurance Specialist for per diem coverage in Utilization Management. You will support authorizations, extract data from medical records, and coordinate with nurses and providers to ensure timely approvals.

Responsibilities include processing admissions authorizations, communicating health plan benefits, and supporting quality improvement activities. On-site role with day shifts and a focus on compliant, cost-effective patient care.

Qualifications

• High School Diploma or Associate degree in a healthcare related field preferred.
• One year experience in a healthcare environment utilizing medical terminology or completed college level course in medical terminology.
• One year of case management, utilization review/billing or coding experience preferred.

Responsibilities

• Initiates and ensures authorizations for all admissions.
• Extracts meaningful data from the medical record of identified patients.
• Processes electronic communications within identified process standards.
• Actively participates in quality activities by communicating and coordinating with the care management team in the development of tools for optimal consumer outcomes and report findings.
• Clarifies health plan medical benefits, policies and procedures for members, physicians, medical office staff, contract providers, and outside agencies.
• Reviews service denials and gathers necessary supporting documentation from chart audits and follows up according to procedures.

Skills

Medical terminology

Case management

Utilization review

Billing

Coding

Education

High School Diploma / Associates degree in healthcare

Job description

Trinity Health Mid-Atlantic is seeking a part-time Insurance Specialist for per diem coverage in Utilization Management. You will support authorizations, extract data from medical records, and coordinate with nurses and providers to ensure timely approvals.

Responsibilities include processing admissions authorizations, communicating health plan benefits, and supporting quality improvement activities. On-site role with day shifts and a focus on compliant, cost-effective patient care.