Utilization Review Support Specialist

Novant Health; Mount Pleasant (SC); Hybrid; USD 34,000 - 48,000; Full time

Benefits offered by this job

Comprehensive benefits

Retirement fund with matching

Tuition assistance

Employee assistance programs and/or 
d

Hybrid work opportunity

Job summary

Novant Health is seeking a detail-oriented administrative professional to support the Utilization Review (UR) team. The role involves scheduling, payer communications, authorization tracking, and maintaining accurate documentation.

You will manage UR office operations, process authorizations and denials, and ensure timely communications with payors while upholding compliance and quality standards.

Qualifications

• Excellent interpersonal and customer service skills.
• Working knowledge of personal computers and software including Microsoft Office products.
• Perform clerical duties with accuracy and attention to detail.
• Effective written and verbal communication; good spelling and grammar.

Responsibilities

• Provide administrative and technical support to the Utilization Review team to ensure timely payer communication, authorization tracking, and accurate documentation.
• Manage daily operations of the onsite Utilization Review (UR) office, including processing mail, answering phone inquiries, making calls to verify authorizations and denial determinations, and faxing communications for multiple facilities.
• Process denials within a strict timeframe and manage payor work queues to avoid adverse determinations.
• Facilitate EMR access by sending census reports to payors.
• Process large volumes of confidential patient and payer information to support billing workflows (including authorizations, denials, and indexing faxes).
• Establish and maintain effective work relationships with internal and external customers.
• Maintain compliance and regulatory standards and organizational policies.

Skills

Interpersonal skills

Customer service

Microsoft Office

Attention to detail

Organizational skills

Education

High School Diploma or GED

Tools

Microsoft Office Suite

Job description

• Comprehensive benefits include medical, dental, vision, and life insurance.
• Retirement fund with matching contributions.
• Tuition assistance for qualifying team members.
• Employee assistance programs and discounts.
• Hybrid work opportunity.

What We Offer

• Comprehensive benefits include medical, dental, vision, and life insurance.
• Retirement fund with matching contributions.
• Tuition assistance for qualifying team members.
• Employee assistance programs and discounts.
• Hybrid work opportunity.

What You'll Do

• Schedule: Monday - Friday, daytime hours, rotating holidays.
• Provide administrative and technical support to the Utilization Review team to ensure timely payer communication, authorization tracking, and accurate documentation.
• Manage daily operations of the onsite Utilization Review (UR) office, including processing mail, answering phone inquiries, making calls to verify authorizations and denial determinations, and faxing communications for multiple facilities.
• Process denials within a strict timeframe and manage payor work queues to avoid adverse determinations.
• Facilitate EMR access by sending census reports to payors.
• Process large volumes of confidential patient and payer information to support billing workflows (includes managing payor communications, processing authorizations, addressing denials, and indexing faxes).
• Establish and maintain effective work relationships with both internal and external customers.
• Maintain compliance and regulatory standards and organizational policies.

Required

What We're Looking For

• Education: High School Diploma or GED.
• Experience: Minimum of one year of clerical and healthcare experience.
• Additional Skills (required): Excellent interpersonal and customer service skills. Working knowledge of personal computers and software including specific knowledge of Microsoft office products. Perform clerical duties with accuracy. Proficient spelling and grammatical skills. Attention to detail with excellent planning and organizational skills. Communicate effectively in both oral and written forms. Keyboard/type accurately. Ability to operate standard office equipment including, but not limited to, a calculator, fax machine, copier, printer and scanner. Establish and maintain effective work relationships. Ability to successfully complete generic and department specific skills validation and competency testing.

Preferred

• Knowledge of Microsoft Office products with proficiency in Excel and Word.
• Revenue cycle experience working with different payer types and working knowledge of their requirements.

Why Choose Novant Health?

At Novant Health, we believe remarkable care starts with compassion for our patients, our communities, and each other. We value belonging, courage, personal growth, and teamwork, creating a space where everyone is respected, supported, and safe to show up as their full selves.