Licensed Utilization Management Coordinator
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Utilization Management Coordinator
(Home-Based) - Prior Authorization.
Key Responsibilities
Monitor utilization of resources, risk management, and quality of
care for patients
Obtain and maintain documentation for services in line with
reimbursement agency guidelines
Input data into computer systems for insurance communication and
monitor patient hospitalization for medical necessity
Required Qualifications
Seven years of relevant experience, with at least one year in
healthcare or clinical settings
Current unencumbered Licensed Practical Nurse (LPN) license or
Registered Health Information Technician (RHIT) certification
Experience in healthcare reimbursement, insurance industry, and/or
authorization is preferred
Relevant coding certifications (e.g., CCS, CPC) are acceptable
Must maintain required department-specific competencies and
certifications
Keywords: VirtualVocations, Orange , Licensed Utilization Management Coordinator, Executive , Vista, California
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