Utilization Review Coordinator

Roswell Park Comprehensive Cancer Center

1d

About The Position

Join a mission-driven team dedicated to delivering high-quality, cost-effective patient care. In this role, you’ll support Case Management and Utilization Management operations by helping ensure patients receive the right care at the right time. Acting as a key liaison between clinical teams, administration, and payers, you will coordinate authorizations, review medical records against established criteria, and manage essential data that supports accurate claims processing. You’ll collaborate with insurers and providers to strengthen documentation, streamline authorization workflows, and prevent denials — all while maintaining compliance with regulatory standards and organizational policies. This position plays a critical role in advancing efficient, patient-centered services and enhancing the overall care experience.

Requirements

• Bachelors degree in a health-related field and a minimum of four (4) years of full-time experience in a medical office setting; or
• Associate’s Degree in a health-related field and a minimum of six (6) years of full-time experience in a medical office setting; or
• High School Diploma or High School Equivalency Diploma and a minimum of eight (8) years of full-time experience in a medical office setting.
• Degrees must be conferred by an accredited school, college, or university, or by an institution recognized by Roswell Park Comprehensive Cancer Center and/or Health Research Incorporated as adhering to acceptable educational standards.

Nice To Haves

• Preferred candidates will bring a minimum of 10 years of experience in a medical or physician office setting and a strong understanding of healthcare operations and workflows.
• Ideal applicants have demonstrated expertise in obtaining and managing insurance authorizations, navigating payer requirements, and ensuring timely approvals.
• Experience preparing and submitting appeals and managing denials is highly valued, including the ability to identify trends and support resolution efforts.
• Candidates should be comfortable communicating with insurance companies to verify benefits, resolve coverage issues, and support accurate claims processing.
• Proficiency using insurance portals such as Availity is preferred, along with experience working in electronic medical record and care coordination systems including Athena, Roswell EMR, and Careport.
• A background in healthcare administration or case management, with an understanding of care coordination and utilization processes, is strongly desired.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level