Utilization & Authorization Review Coordinator - Rehab

International Executive Service Corps; Lawton (OK); On-site; USD 42,000 - 56,000; Full time

Job summary

International Executive Service Corps in Oklahoma is seeking a Utilization & Authorization Review Coordinator to manage end-to-end authorization for outpatient therapies, acting as a bridge between therapy teams, patients, and payors.

The role emphasizes ensuring medical necessity, preventing denials, and optimizing care within plan guidelines. A high school diploma is required, with college degree preferred; 2+ years in utilization management and computer proficiency are expected.

Qualifications

• Requires 2+ years in healthcare utilization management.
• High school diploma; college degree preferred.
• Clinical licensure preferred.
• Proficient computer skills required.

Responsibilities

• Manage end-to-end authorization for outpatient therapies.
• Bridge between therapy team, patients, and payors to secure approvals.
• Prevent claim denials and optimize care delivery within plan guidelines.
• Review records for Intensity of Service and Severity of Illness against criteria.
• Assist staff with potential denials and complete the review updates.
• Obtain authorization and current plan of care documents.

Skills

Healthcare utilization management

Computer proficiency

Medical coding (ICD, CPT)

Payor web portals

Education

High school diploma

College degree preferred

Clinical licensure preferred

Job description

DEFINITION: All duties and criteria-based standards within this document will be performed according to established policies, procedures, and guidelines within the department and hospital. The Utilization & Authorization Review Coordinator is responsible for managing the end-to-end authorization process and ensuring the medical necessity of outpatient physical , occupational and speech therapies. This role acts as a bridge between the clinical therapy team, patients, and insurances to secure approvals, prevent claim denials, and optimize the delivery of care within plan guidelines. Reviews patient records for documentation of Intensity of Service and Severity of Illness and compares against established criteria. Assists the medical staff with potential denials and interacts to complete the review process. Completes insurance company clinical review updates. Obtains authorization and current plan of care documents for outpatient therapies.

EDUCATION: High school diploma. College degree preferred.

LICENSURE/CERTIFICATION/REQUIREMENTS: This role can be administrative, however, a clinical licensure is preferred. Must have 2+ years experience in healthcare utilization management. Must have computer competency.

PREFERRED QUALIFICATIONS:

• Clinical Degree
• Experience w/ Medical coding (ICD, CPT) and payor web portals
• Experience in an outpatient therapy clinical setting.
• Prior medical record background, plus prior experience in utilization review are preferred.