PRN Utilization Review Coordinator - Behavioral Health

Universal Hospital Services Inc.; Lawrenceville (GA); On-site; USD 55,000 - 75,000; Part time

Job summary

SummitRidge Hospital in Lawrenceville, GA is seeking a PRN Utilization Review Coordinator to support behavioral health services. You will coordinate utilization review activities, obtain and track insurance authorizations, and ensure timely care alignment with payer requirements.

The role emphasizes accuracy, confidentiality, and collaboration with clinical staff. The ideal candidate has experience in utilization review or case management within healthcare, strong organizational and

Qualifications

• High school diploma or equivalent required; associate’s or bachelor’s degree preferred.
• Previous experience in utilization review, case management, behavioral health, or related healthcare setting preferred.
• Knowledge of insurance authorization processes, payer requirements, and medical necessity criteria.
• Strong organizational, communication, and problem-solving skills.
• Ability to work independently and maintain professionalism in a fast-paced environment.
• Proficiency with computer systems and electronic documentation.
• Previous experience with third party payors.
• Must be familiar with utilization negotiations.

Responsibilities

• Conduct utilization review functions for assigned patients in accordance with facility policies and payer guidelines.
• Obtain, track, and maintain insurance authorizations, continued stay reviews, and discharge planning updates.
• Communicate effectively with insurance companies, clinical staff, and other care team members.
• Ensure documentation is accurate, timely, and compliant with regulatory and payer standards.
• Support coordination of patient care updates related to level of care and medical necessity.
• Assist with appeals, denials, and other utilization management processes as needed.
• Maintain confidentiality and adhere to all HIPAA and facility privacy standards.

Skills

Organizational skills

Communication skills

Problem-solving

Independence

Proficiency with computer systems

Education

High school diploma or equivalent

Job description

SummitRidge Hospital in Lawrenceville, GA is seeking a PRN Utilization Review Coordinator to support behavioral health services. You will coordinate utilization review activities, obtain and track insurance authorizations, and ensure timely care alignment with payer requirements.

The role emphasizes accuracy, confidentiality, and collaboration with clinical staff. The ideal candidate has experience in utilization review or case management within healthcare, strong organizational and