Remote Utilization Management Specialist

CorroHealth Inc; Pennsylvania; Hybrid; USD 30,000 - 39,000; Full time

Benefits offered by this job

Medical/Dental/Vision Insurance

401k matching (up to 2%)

PTO: 80 hours accrued, annually

9 paid annual holidays

Life Insurance

Short/Long term disability options

Tuition reimbursement

Professional growth and more!

Job summary

CorroHealth Inc. seeks a remote Utilization Management Coordinator to manage end-to-end authorization, from notification through discharge, within US hours. You will document in EMR and payer portals, verify eligibility, and liaise with hospitals and payers to prevent delays while ensuring HIPAA compliance.

This role supports a dynamic revenue cycle environment. Required are 2 years of related experience, knowledge of managed care contracts, and proficiency in MS Office.

Qualifications

• High School Diploma or equivalent required.
• Associate degree in healthcare administration preferred.
• 2 years of experience in hospital related billing/follow-up/authorization field.
• Knowledge of managed care contracts.
• Experience with customer support and issue resolution.
• Strong understanding of medical terminology and insurance processes.
• Experience working in EMR systems, Epic preferred.
• Excellent communication and organization skills.
• Strong multi-tasking in a fast-paced environment.
• Proficiency with MS Office and web systems.

Responsibilities

• Manage the Authorization process end to end from initial notification to determination and discharge.
• Maintain detailed documentation in EMR, CorroHealth system and Health Payer portals.
• Verify eligibility and benefits for patients.
• Liaise between hospital staff and Health Payer to facilitate information sharing.
• Review timely filing guidelines for utilization management.
• Track and follow up with payers on pending authorizations.
• Contact payer for status updates and to remove processing hurdles.
• Identify escalation issues causing delays or denials.
• Manage workload with timely follow up and accurate records.
• Maintain HIPAA and other healthcare regulations compliance.

Skills

Communication skills

Organization skills

Multi-tasking

MS Office

Medical terminology

Customer support

Education

High School Diploma or equivalent

Associate degree in healthcare administration

Tools

Epic EMR

Health payer portals

Internet/Web systems

Job description

CorroHealth Inc. seeks a remote Utilization Management Coordinator to manage end-to-end authorization, from notification through discharge, within US hours. You will document in EMR and payer portals, verify eligibility, and liaise with hospitals and payers to prevent delays while ensuring HIPAA compliance.

This role supports a dynamic revenue cycle environment. Required are 2 years of related experience, knowledge of managed care contracts, and proficiency in MS Office.