Utilization Management Admin Specialist

OhioGuidestone; Berea (OH); On-site; USD 38,000 - 54,000; Full time

Benefits offered by this job

Stable nonprofit with 160+ year track

10 paid holidays

Flexible work schedules

401(k) with employer match

Employee Assistance Program (EAP)

Recognition and rewards

Job summary

OhioGuidestone in Ohio is seeking an Administrative Specialist to support the Billing department. You will receive, review, and route authorization and utilization management requests, verify information, and enter data into internal systems to keep workflows moving smoothly.

This role requires a high school diploma (associate or bachelor preferred) and 1–3 years in healthcare administration or related fields.

Qualifications

• High school diploma or GED required; higher degree preferred.
• 1–3 years of experience in healthcare administration or related fields.
• Experience with EMR, health plan, authorization, or case-management systems preferred.
• Proficient with technology including EHRs and Microsoft Office.

Responsibilities

• Provide administrative and operational support to the Billing department.
• Receive, review, and route authorization and utilization management requests.
• Verify member, provider, authorization, and service information for completeness and accuracy.
• Enter and maintain authorization data in internal systems.
• Monitor requests and cases to ensure information and deadlines are met.
• Prepare reports, spreadsheets, and status updates for Utilization Management.

Skills

Tech proficient

Interpersonal skills

Independent and collaborative

Flexible scheduling

Education

High school diploma or GED

Associate or bachelor's degree preferred

Tools

Electronic Medical Records (EMR) systems

Microsoft Office Suite

Job description

OhioGuidestone in Ohio is seeking an Administrative Specialist to support the Billing department. You will receive, review, and route authorization and utilization management requests, verify information, and enter data into internal systems to keep workflows moving smoothly.

This role requires a high school diploma (associate or bachelor preferred) and 1–3 years in healthcare administration or related fields.