Remote Utilization Management Coordinator

HonorHealth; Phoenix (AZ); Remote; USD 42,000 - 56,000; Full time

Job summary

HonorHealth in Virtual Arizona is seeking a Case Management support role to assist in Utilization Management operations. You will help organize workflow, communicate with payers, and document in EPIC, ensuring timely approvals for admissions.

This role emphasizes accurate data handling and collaboration with UM nurses and Care Coordination. Day shift, remote role from Monday to Friday, 7:30am–4:00pm, with duties including processing faxed requests, tracking denials, and maintaining compliant

Qualifications

• High School Diploma or GED required.
• Associates degree preferred.

Responsibilities

• Performs a variety of routine clerical tasks and revenue optimizing activities according to department workflows.
• Monitors RightFax daily for inbound faxes from payers and renames them per conventions.
• Uploads payer approvals, bed days and denials to appropriate patient accounts in EMR/EPIC.
• Documents EMR/EPIC Auth/Cert and Communications and faxes initial or continued stay clinicals to payers.
• Follows up on fax fails until resolved and reports HIPAA breaches as required.
• Collaborates with Preservices and Care Coordination teams to ensure payer coverage and accurate admissions data.
• Coordinates concurrent denial resolution with nursing and physician advisor teams and facilitates peer-to-peer reviews with payers.

Education

High School Diploma or GED

Associate degree

Job description

HonorHealth in Virtual Arizona is seeking a Case Management support role to assist in Utilization Management operations. You will help organize workflow, communicate with payers, and document in EPIC, ensuring timely approvals for admissions.

This role emphasizes accurate data handling and collaboration with UM nurses and Care Coordination. Day shift, remote role from Monday to Friday, 7:30am–4:00pm, with duties including processing faxed requests, tracking denials, and maintaining compliant