Utilization & Provider Authorization Specialist

Harris Health; Houston (TX); On-site; USD 45,000 - 65,000; Full time

Job summary

Community Health Choice, Inc. in Houston seeks a UM Coordinator to support provider authorization processes, data entry in the Utilization Module, and non-clinical service requests.

The role requires accurate data capture and strong communication with providers to aid clinical decision-making and transport coordination. Experience in managed care or insurance is preferred, with proficiency in Microsoft Office and a commitment to regulatory timelines and CHC guidelines.

Qualifications

• High School or equivalent is required.
• Some college experience is preferred.
• Three years of referrals/authorization experience.
• At least one year insurance-related experience in a managed care environment.

Responsibilities

• Data entry of requests for authorization for admissions and other services.
• Answer provider hotline calls in a timely and professional manner.
• Coordinate with nursing or medical staff as needed.
• Assist with regulatory timelines and CHC guidelines.

Skills

Data entry

Phone handling

Communication

Education

High School or equivalent

Some years of college, preferred

Tools

Microsoft Office

Job description

Community Health Choice, Inc. in Houston seeks a UM Coordinator to support provider authorization processes, data entry in the Utilization Module, and non-clinical service requests.

The role requires accurate data capture and strong communication with providers to aid clinical decision-making and transport coordination. Experience in managed care or insurance is preferred, with proficiency in Microsoft Office and a commitment to regulatory timelines and CHC guidelines.