Utilization Management Coordinator

adventhealth; Orlando (FL); On-site; USD 24,287 - 38,848; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

Paid time off

403(b) retirement plan

Parental leave

Career development

Well-being resources

Mental health resources

Pet benefits

Job summary

AdventHealth in Altamonte Springs, FL is seeking a Utilization Management Clerk to monitor payor communications, enter approvals and denials, and support daily operations within the Utilization Management team.

The role requires strong Microsoft Office skills, professional communication, and the ability to multitask with minimal supervision. Prior healthcare or patient finance exposure is preferred to promote efficient workflow.

Qualifications

• Proficient with Microsoft Office and related software.
• Effective written and verbal communication skills.
• Ability to manage multiple tasks and prioritize.
• Commitment to quality patient care and customer service.

Responsibilities

• Monitors electronic faxes and emails from payors and forwards to relevant team members.
• Enters approval and denial information into Utilization Management systems.
• Supports clerical and administrative activities of the Utilization Management team.
• Manages the centralized phone line for payor communications.
• Uploads payor letters to patient encounters and forwards to applicable departments.
• Tracks payor issues and potential contractual issues; escalates to leadership as needed.
• Performs other duties to support daily operations and special projects.

Skills

Microsoft Office

Communication

Multitasking

Education

High School Diploma or GED

Associate degree preferred

Job description

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose‑minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403‑B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well‑being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule: Full time

Shift: Day (United States of America)

Address: 900 HOPE WAY

City: ALTAMONTE SPRINGS

State: Florida

Postal Code: 32714

Job Description:

Monitors and addresses electronic faxes and emails from payors. Forwards communication to appropriate Utilization Management team members. Supports clerical and administrative activities of the Utilization Management team. Enters pertinent approval and denial information into the appropriate computer programs for Utilization Management team members to review and address in a timely manner. Monitors the Centralized Phone Line for telephonic authorization and denial information from payors. Manages and monitors mail from the department mailbox, including uploading letters from payors to patient encounters and forwarding correspondences to applicable departments. Tracks and trends payor issues and potential contractual issues, escalating to Utilization Management leadership. Manages multiple clerical duties and assigned projects, supporting daily operational flows and special projects as required. All other duties as assigned.

Knowledge, Skills, and Abilities:

• Understanding of Microsoft Office Products and other appropriate software platforms [Required]
• Ability to communicate effectively and professionally via phone and email [Required]
• Ability to manage multiple tasks and prioritize level of importance [Required]
• Ability to perform duties in a manner to promote quality patient care and customer service/satisfaction, while promoting safety and a commitment to AH principles [Required]
• Ability to work with people of all social, economic, and cultural backgrounds; be flexible, open‑minded and adaptable to change [Required]
• Ability to work with minimal supervision [Required]
• Knowledge of Utilization Management processes [Preferred]
• Knowledge of Care Management processes/workflows [Preferred]

Education:

• Associate [Preferred]
• High School Grad or Equiv [Required]

Field of Study:

• social work

Work Experience:

• Experience in health care, hospital setting, and/or Patient Finance Services [Required]

Additional Information:

• N/A

Licenses and Certifications:

• N/A

Physical Requirements - https://tinyurl.com/23km2677

Pay Range: $17.63 - $28.20

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at: https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti‑discrimination laws, regulations and ordinances.