Utilization Review Coordinator

UHS•Mountain City, TN

4d•Onsite

About The Position

Mountain Youth Academy is seeking a detail-oriented and organized Utilization Review Coordinator to join our Business Office team. This position plays a vital role in ensuring our students receive uninterrupted insurance coverage by coordinating timely insurance reviews, maintaining utilization management records, and serving as a liaison between insurance providers, referral sources, and internal departments. The ideal candidate is highly organized, possesses excellent communication and customer service skills, and thrives in a fast-paced healthcare environment.

Requirements

High school diploma or GED.
1+ year(s) of related administrative or healthcare experience.
Strong computer proficiency, including Microsoft Office (Excel and Word).
Excellent verbal and written communication skills.
Strong customer service and organizational skills.
Experience navigating multiple web-based portals.

Nice To Haves

Knowledge of insurance authorization processes is preferred.

Responsibilities

Submit initial and concurrent insurance reviews to ensure continued authorization and coverage.
Complete insurance eligibility verifications twice monthly.
Coordinate daily and weekly admission and discharge utilization processes.
Maintain utilization management databases and spreadsheets.
Prepare weekly, monthly, and quarterly utilization reports, including reports for the Utilization Management Committee.
Communicate effectively with insurance representatives, referral sources, and internal leadership.
Participate in monthly Zoom meetings and other department meetings.
Perform additional duties as assigned.