Utilization Review Data & Authorization Coordinator

KPC GLOBAL MEDICAL CENTERS INC.; Santa Ana (CA); On-site; USD 34,000 - 51,000; Full time

Job summary

KPC GLOBAL MEDICAL CENTERS INC. in Santa Ana, CA is seeking an Utilization Review Technician. Under supervision of the Utilization Review Supervisor, you will coordinate with the Utilization Management Department, manage phone calls and clinical requests, perform data entry, track authorizations and denials, and prepare appeals for submission.

This is a full-time, non‑RN/LVN, on-site role. Requires a High School Diploma; healthcare experience preferred, excellent verbal and written

Qualifications

• High School Diploma required.
• Healthcare experience preferred.
• Excellent verbal and written communication required.
• Strong organizational and time-management skills.
• Proficient with Microsoft Office and data-entry tasks.

Responsibilities

• Coordinate phone calls and clinical requests with the Utilization Management Department.
• Perform data entry and maintain accurate records of authorizations and denials.
• Prepare and mail/fax appeals; track data from insurers and health plans.
• Review treatment plans and monitor insurer approvals or denials.
• Ensure HIPAA compliance and protect patient confidentiality.

Skills

Verbal communication

Written communication

Organizational skills

Time management

Microsoft Office

CMS/NCQA knowledge

Education

High School Diploma

Healthcare experience preferred

Tools

Microsoft Excel

Data entry

Job description

KPC GLOBAL MEDICAL CENTERS INC. in Santa Ana, CA is seeking an Utilization Review Technician. Under supervision of the Utilization Review Supervisor, you will coordinate with the Utilization Management Department, manage phone calls and clinical requests, perform data entry, track authorizations and denials, and prepare appeals for submission.

This is a full-time, non‑RN/LVN, on-site role. Requires a High School Diploma; healthcare experience preferred, excellent verbal and written