Utilization Review Department Coordinator

Holy Cross Health Fl; Fort Lauderdale (FL); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a dedicated Utilization Review Department Coordinator to enhance operational efficiency and provide essential administrative support. In this role, you will manage communication with payors and providers, ensuring timely authorizations and seamless operations. Your expertise in medical office administration and customer service will be vital as you promote teamwork and effective communication within the department. Join a compassionate healthcare environment that values holistic care and offers comprehensive benefits from day one. This position is perfect for those looking to make a meaningful impact in a supportive setting.

Benefits

Comprehensive medical benefits

Dental and vision coverage

Paid time off

403B retirement plan

Education assistance

Employer matching for retirement savings

Qualifications

• 2-3 years of experience in Medical Office administration or related roles.
• Strong skills in insurance authorizations and denials management.

Responsibilities

• Manage back-office functions for Utilization Review.
• Interface with payors and providers for authorizations.
• Coordinate Physician Advisor referrals using Indicia/InterQual.

Skills

Medical Office Administration

Customer Service

Insurance Authorizations

Denials Management

Communication Skills

Education

Tech/Trade Certificate

High School Diploma

Job description

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Description:

Employment Type: Full time

Shift: Day shift (if applicable, specify here)

Position Purpose

Responsible for the overall organization and daily operational functions related to administrative/clerical support for Utilization Review. Under the direction of the Care Coordination Department Leadership, the UR Coordinator manages all back-office functions of the Utilization Review Department, interfaces with payors and providers requesting authorizations, medical records, and other information, confirms review completeness, and directs concurrent denials to appropriate staff.

What You Will Do

• Interface with payors and providers requesting authorizations, medical records, and other information.
• Manage clinical review work queues assigned to Utilization Management.
• Coordinate Physician Advisor referrals regarding care level criteria using Indicia/InterQual, review referrals with department managers as needed.
• Report uncovered or at-risk days to leadership.
• Promote teamwork and effective communication with team members including Utilization Management RNs, care managers, nursing staff, secretaries, insurance reps, etc.
• Ensure seamless communication with payers, including retrieving voicemails and faxes, transcribing information into electronic records, and maintaining professional communication.
• Perform basic reception functions to support office operations, such as answering calls, maintaining filing systems, restocking supplies, and managing office equipment.
• Perform other duties as assigned.

Minimum Qualifications

• 2-3 years of experience in Medical Office administration, customer service, or related roles such as insurance authorizations and denials management.

Minimum Education

• Tech/Trade Certificate or High School Diploma.

Position Highlights and Benefits

• Comprehensive benefits including medical, dental, vision, paid time off, 403B, and education assistance.
• Serving within a compassionate, Catholic healthcare environment committed to holistic, person-centered care.
• Living our guiding behaviors: teamwork, open communication, accountability, trust, continuous learning.

Facility Information

• Holy Cross Hospital in Fort Lauderdale, FL, is a full-service, non-profit Catholic hospital sponsored by the Sisters of Mercy, part of Trinity Health.
• Dedicated to compassionate, holistic care; the only Catholic hospital in Broward and Palm Beach counties.
• Part of Trinity Health, serving communities across 21 states with nearly 2.8 million visits annually.
• Benefits begin on the first day of employment, including a retirement savings program with employer matching.

Legal and Diversity Statements

We are an Equal Opportunity Employer committed to diversity, equity, and inclusion. We do not discriminate based on race, color, religion, sex, age, national origin, sexual orientation, gender identity, veteran status, disability, or any other protected class.