Healthcare Utilization Review Intake Coordinator

Description

Position:
Utilization Review Intake Coordinator

Location:

Remote/ Hybrid our of Exeter, NH or South Burlington,VT

Employment Status:
Full-time, non-exempt

Summary

Under the supervision of the Utilization Review Manager or assignees, the Utilization Review Intake Coordinator is responsible for managing the initial intake and data entry of clinical information required for the utilization review processes. This includes verifying patient information, preparing and submitting authorization requests to the nursing staff or external UR vendor AHH. The intake coordinator plays a key role in ensuring timely reviews and preventing delays in treatment.

Key Responsibilities

• Supports the daily operations of the Utilization Review department by assisting the Lead Utilization Review Intake Coordinator with various requested tasks.
• Data entry of clinical and intake information to the appropriate platform, directed to the appropriate vendor.
• Maintains a current knowledge base of UR processes and timelines.
• Uses good listening skills, conducts outreach calls, collects data according to script, tools, and protocols meeting both productivity and performance expectations as identified by the lead and manager. Conducts all calls in a courteous and customer service friendly manner. Refers to appropriate staff when indicated by workflow.
• Processes incoming and outgoing correspondence/faxes as assigned in accordance with required standards and within respective timeliness guidelines. Referring to the appropriate clinical team members for review as defined by workflow.
• Clerical responsibilities such as processing urgent scanning, and document retrieval routed to UR.
• Demonstrates a professional and courteous manner when communicating with others with the ability to state clearly and accurately the agreed upon resolution.
• Adhere to, Standard Operating Procedures and maintains current knowledge of member benefits, rights and responsibilities.
• Performs other related duties and projects as assigned within the assigned time frames.
• Interprets Plan language and applies to intake tasks.
• Adheres to company policies and procedures.

Requirements

Qualifications

• High school diploma or equivalent required.
• Minimum of 1-2 years of experience in healthcare field.
• Fluent computer skills including MS Office (Word, Excel, and Outlook) and Internet applications.
• Strong reading comprehension

Personal Attributes

• Initiative & Independence – Takes ownership of tasks and drives work forward without the need for constant supervision.
• Decision-Making – Applies critical thinking and sound judgment to make informed choices, clearly explaining the rationale behind decisions.
• Communication & Problem-Solving – Engages in clear, professional communication and identifies effective solutions to challenges.
• Attendance & Reliability – Maintains regular, reliable attendance during assigned work hours to meet operational needs.
• Engagement & Presence – Remains attentive and actively engaged during scheduled shifts to perform essential job responsibilities

Benefits

After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:

Competitive medical, dental, and vision insurance*

Twice-yearly employer HSA contributions covering up to 50% of the HDHP plan annual deductible

Company-paid basic life and AD&D insurance

Company-paid short-term and long-term disability coverage**

Flexible spending accounts (FSAs)*

401(k) retirement savings plan with up to a 6% employer match** (100% vested after three years)

10+ paid company holidays annually

Early-release Summer Fridays

Generous paid vacation and sick time

Annual volunteer day

Annual tuition reimbursement

Annual health and wellness reimbursement

Employee appreciation events and team activities throughout the year

Benefit Waiting Period Notes:
* 60 day waiting period
** 90 day waiting period