Utilization Management Coordinator

Pacific Temporary ServicesRancho Cordova, CA
Onsite

About The Position

Our client, a respected healthcare organization, is seeking a Utilization Management Coordinator. This role plays a key part in supporting care coordination operations through accurate referral processing, prior authorization review, and timely communication with members and providers. This is a long term temporary opportunity with potential for hire. The ideal candidate will have at least three years of experience in a medical office, with hands-on responsibility for processing referrals and prior authorizations, and will demonstrate excellent customer service skills when supporting patients and clinical staff.

Requirements

  • High school diploma or GED required.
  • 3+ years of experience in a medical environment using computer programs.
  • Ability to work independently and collaboratively across multiple teams.
  • Strong attention to detail, accuracy, and data entry skills.
  • Professional communication skills and ability to maintain confidentiality.
  • Ability to use good judgement.
  • Must be able to pass a background check and drug screen.

Nice To Haves

  • Experience with insurance processes (preferred).
  • Working knowledge of front/back-office operations and ICD 9/scheduling systems (preferred).

Responsibilities

  • Process prior authorizations, verify eligibility, and manage referrals using established criteria.
  • Create and update inpatient and referrals, including data entry and coordination with liaisons.
  • Prepare and distribute referral outcome notifications to members, providers, and regulatory bodies.
  • Track and document appeal and grievances, ensuring timely follow up.
  • Support UM meetings through scheduling, agendas, minutes, and clerical coordination.
  • Monitor admissions/discharges and assist with referral reporting.
  • Maintain accurate records and contribute to a positive, customer focused work environment.
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