Utilization Review Support Specialist

Novant Health; Parish Place (SC); Hybrid; USD 36,000 - 48,000; Full time

Benefits offered by this job

Medical, dental, vision, and life-ins

Tuition assistance

Retirement fund with matching

Hybrid work

Job summary

Novant Health is seeking an Administrative/Utilization Review support specialist for a hybrid role in South Carolina. You will provide administrative and technical support to the Utilization Review team, ensuring timely payer communications, accurate documentation, and proper authorization tracking.

Responsibilities include onsite UR operations, processing denials within deadlines, enabling EMR census reporting to payors, and handling large volumes of confidential patient and payer data to

Qualifications

• Education requirement: High School Diploma or GED.
• Minimum of one year of clerical and healthcare experience.
• Excellent interpersonal and customer service skills.
• Proficient spelling and grammar with strong written communication.
• Attention to detail and strong organizational skills.
• Ability to operate standard office equipment and basic IT tools.
• Experience with EMR or payer communications is a plus.

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 office, including processing mail, answering phones, and contacting payors to verify authorizations and denials.
• Process denials within a strict timeframe and manage payor work queues.
• Facilitate EMR access by sending census reports to payors.
• Handle large volumes of confidential patient and payer information to support billing workflows.
• Establish and maintain effective work relationships with internal and external customers.
• Maintain compliance with regulatory standards and organizational policies.

Skills

Interpersonal skills

Customer service

PC literacy

Microsoft Office

Attention to detail

Communication skills

Office equipment

Team relationships

Education

High School Diploma or GED

Tools

Microsoft Office

Job description

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.

What We're Looking For

Required:

• 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.

Job Opening ID

185138