Licensed Utilization Management Coordinator

Company: VirtualVocations
Location: Lincolnwood
Posted on: March 28, 2025

Job Description:

A company is looking for a Utilization Management Coordinator (Home-Based) - Prior Authorization.
Key Responsibilities

Monitor resource utilization, risk management, and quality of care in accordance with established guidelines
Obtain and maintain documentation for services to ensure compliance with reimbursement agency guidelines
Input data into systems for insurance communication and assist with medical records coding as needed

Required Qualifications

Seven years of relevant experience with a minimum of one year in healthcare or clinical settings
Current unencumbered Licensed Practical Nurse (LPN) license or Registered Health Information Technician (RHIT) certification
Relevant certifications in coding or pharmacy, such as Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
Experience in healthcare reimbursement, insurance industry, and/or authorization processes is preferred
Ability to maintain required department-specific competencies and certifications

Keywords: VirtualVocations, Chicago , Licensed Utilization Management Coordinator, Executive , Lincolnwood, Illinois

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