Remote Payor Specialist: Authorization & UM Expert

aah; Charlotte (NC); On-site; USD 30,100 - 45,185; Full time

Benefits offered by this job

Paid Time Off

Health benefits

Flexible Spending Accounts

Retirement plan

Educational assistance

Parental leave

Job summary

Advocate Health is seeking a remote Utilization Management professional in Charlotte, NC for a full-time 100% remote role with 40 hours per week. Compensation ranges from $21.85 to $32.80 per hour, with benefits eligibility and a typical Monday–Friday schedule.

You will handle payor negotiations, provide feedback on determinations, and manage certification data in the system while ensuring compliance and customer satisfaction.

Qualifications

• High School Diploma or GED required; Associates/Bachelors preferred in health-related field.
• Experience with Third Party Reimbursement or Utilization Management is preferred.
• Knowledge of medical terminology is preferred.

Responsibilities

• Communicates clinical information and negotiates with payors to obtain authorization for appropriate level of care and length of stay.
• Provides prompt feedback regarding payor determinations to appropriate staff.
• Obtains preferred provider and benefit information for home care, DME and post acute services.
• Maintains and enters certification information in the information system.

Skills

Payor communication

Medical terminology

Documentation

Customer service

Education

High School Diploma or GED

Associates or Bachelors preferred

Job description

Advocate Health is seeking a remote Utilization Management professional in Charlotte, NC for a full-time 100% remote role with 40 hours per week. Compensation ranges from $21.85 to $32.80 per hour, with benefits eligibility and a typical Monday–Friday schedule.

You will handle payor negotiations, provide feedback on determinations, and manage certification data in the system while ensuring compliance and customer satisfaction.