UR COORDINATOR

UHS • Lawrenceville, GA

7d • Onsite

About The Position

SummitRidge Hospital provides quality behavioral health and addiction treatment services in Lawrenceville, GA, approximately 30 miles northeast of downtown Atlanta. Our dedicated team of professionals provide caring and professional inpatient, outpatient and support services to adults and adolescents suffering from psychiatric or addictive disorders. Additionally, the Geriatric unit provides acute care for seniors in psychiatric crisis.
SummitRidge Hospital is seeking a PRN Utilization Review Coordinator to support our behavioral health facility on an as-needed basis. This role is responsible for coordinating utilization review activities, supporting timely insurance authorization processes, and ensuring compliance with payer requirements. The ideal candidate will have strong communication skills, attention to detail, and experience in behavioral health or utilization management.

Requirements

• High school diploma or equivalent required
• Knowledge of insurance authorization processes, payer requirements, and medical necessity criteria
• Strong organizational, communication, and problem-solving skills
• Ability to work independently and maintain professionalism in a fast-paced environment
• Proficiency with computer systems and electronic documentation
• Previous experience with third party payors.
• Must be familiar with utilization negotiations.

Nice To Haves

• associate’s or bachelor’s degree preferred
• Previous experience in utilization review, case management, behavioral health, or a related healthcare setting preferred

Responsibilities

• Conduct utilization review functions for assigned patients in accordance with facility policies and payer guidelines
• Obtain, track, and maintain insurance authorizations, continued stay reviews, and discharge planning updates
• Communicate effectively with insurance companies, clinical staff, and other care team members
• Ensure documentation is accurate, timely, and compliant with regulatory and payer standards
• Support coordination of patient care updates related to level of care and medical necessity
• Assist with appeals, denials, and other utilization management processes as needed
• Maintain confidentiality and adhere to all HIPAA and facility privacy standards

What This Job Offers

• Education Level: High school or GED