UM Coordinator

Job Description

Job Description

A healthcare company is looking for a detail-oriented UM Coordinator to support utilization management operations for a healthcare organization in Long Beach, California. This UM Coordinator opportunity is ideal for someone with experience in healthcare administration who can manage authorization workflows, maintain accurate records, and provide responsive support to providers. The UM Coordinator follows a Wednesday through Sunday schedule after training, with three days onsite and weekend work performed remotely.

Key Responsibilities:

• Review and process prior authorization submissions using the designated authorization platform while ensuring information is complete and accurate.

• Confirm member coverage, benefit details, and participating provider status before advancing requests for review.

• Maintain thorough documentation of case updates, outreach efforts, provider interactions, and authorization determinations in the appropriate systems.

• Track urgent and routine request timelines closely to help ensure compliance with internal standards and regulatory turnaround requirements.

• Respond to inbound calls, faxes, and portal inquiries from provider offices and route clinical matters to UM nursing staff when escalation is needed.

• Perform high-volume data entry and administrative support tasks with a strong focus on accuracy, organization, and timely follow-up.

• Coordinate communication across teams to help keep authorization activity moving efficiently and resolve issues that may delay processing.

Benefits: Health, Dental, Vision, 401k, and Sick Time Off.

Qualifications:

• High school diploma or equivalent required; an associate degree is preferred.

• At least 1 year of experience in healthcare administration, medical office support, prior authorization, or managed care.

• Working knowledge of medical terminology and familiarity with ICD-10 and CPT/HCPCS coding concepts.

• Understanding of prior authorization procedures and health plan or managed care workflows.

• Ability to interpret eligibility, benefits, and provider participation information accurately.

• Proficiency in Microsoft Outlook, Word, Excel, and Adobe Acrobat.

• Strong customer service, multitasking, and data entry skills in a fast-paced administrative environment.

• Experience with utilization management systems or related healthcare platforms is preferred but not required.