Revenue Cycle Utilization & Authorization Specialist

Anuvia Prevention & Recovery Center; Charlotte (NC); On-site; USD 37,000 - 52,000; Full time

Job summary

Anuvia Prevention & Recovery Center in Charlotte, NC is hiring a full-time Utilization Specialist to own day-to-day utilization management, including MCO enrollments and insurance verification, across programs and locations.

The role requires cross-training across the revenue cycle, collaboration with the Revenue Cycle Manager, and timely authorization submissions to keep clients enrolled and covered. Hours are Monday–Friday, 8:30 AM–5:00 PM.

Qualifications

• Associate's degree or equivalent; Bachelor's preferred.
• Two or more years of experience in healthcare revenue cycle, utilization management, insurance verification, or medical billing.
• Familiarity with NC Medicaid Tailored Plans, EHR authorization tracking, and payer portals preferred.

Responsibilities

• Own day-to-day utilization management work — MCO enrollments, insurance verification and lookup, initial authorization submission, and tracking.
• Submit initial authorization requests across Medicaid MCO, Medicare, and commercial payers and manage reauthorizations.
• Review intake paperwork and perform daily insurance review to ensure eligibility and enrollment targets.
• Support billing tasks when needed, including claim scrubbing, corrections, resubmissions, and remittance reconciliation.
• Collaborate with Revenue Cycle Manager and cross-train across the full workflow to ensure continuity.

Education

Associate's degree preferred; Bachelor's preferred (or equivalent experience)

Two or more years of healthcare revenue cycle experience

Tools

NetSmart EHR

Availity

NaviNet

UHCprovider

Job description

Anuvia Prevention & Recovery Center in Charlotte, NC is hiring a full-time Utilization Specialist to own day-to-day utilization management, including MCO enrollments and insurance verification, across programs and locations.

The role requires cross-training across the revenue cycle, collaboration with the Revenue Cycle Manager, and timely authorization submissions to keep clients enrolled and covered. Hours are Monday–Friday, 8:30 AM–5:00 PM.