PRN Utilization Review Coordinator - Behavioral Health

UHS; Lawrenceville (GA); Hybrid; USD 34,000 - 44,000; Part time

Job summary

SummitRidge Hospital in Lawrenceville, GA, part of Universal Health Services, is seeking a PRN Utilization Review Coordinator to support our behavioral health facility on an as-needed basis. The role focuses on coordinating utilization review activities, securing timely insurance authorizations, and ensuring payer compliance.

You will collaborate with clinical staff and payers, maintain accurate documentation, and assist with appeals and denials while upholding HIPAA standards in a fast-paced

Qualifications

• High school diploma or equivalent required; associate’s or bachelor’s degree preferred.
• Experience in utilization review, case management, or behavioral health preferred.
• Knowledge of insurance authorization processes, payer requirements, and medical necessity criteria.
• Strong organizational and communication skills; ability to work independently.

Responsibilities

• Conduct utilization review functions for assigned patients.
• Obtain, track, and maintain insurance authorizations and discharge updates.
• Communicate with insurance companies, clinical staff, and care team.
• Ensure documentation is accurate, timely, and compliant.
• Support patient care updates related to level of care and medical necessity.
• Assist with appeals, denials, and other utilization management processes.
• Maintain confidentiality and HIPAA compliance.

Skills

Utilization review

Case management

Communication

HIPAA compliance

Medical terminology

Education

High school diploma or equivalent

Associate's or Bachelor's degree preferred

Tools

EMR / EHR systems

Job description

SummitRidge Hospital in Lawrenceville, GA, part of Universal Health Services, is seeking a PRN Utilization Review Coordinator to support our behavioral health facility on an as-needed basis. The role focuses on coordinating utilization review activities, securing timely insurance authorizations, and ensuring payer compliance.

You will collaborate with clinical staff and payers, maintain accurate documentation, and assist with appeals and denials while upholding HIPAA standards in a fast-paced