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 will manage prior authorization activity, maintain accurate records, and communicate effectively with providers in a fast-paced environment. Key Responsibilities:• Review and process prior authorization submissions using the designated authorization platform while ensuring each request is handled accurately and efficiently.• Confirm member coverage details, benefit information, and provider network participation before authorization decisions move forward.• Record case updates, communication history, and status changes in a clear and organized manner within the appropriate systems.• Track request timelines for both urgent and routine cases to help maintain compliance with internal standards and regulatory requirements.• Respond to incoming provider inquiries received by phone, fax, or portal and route clinical matters to UM Nurses when needed.• Support daily utilization management activities by prioritizing multiple requests and maintaining consistent turnaround performance.• Coordinate with internal team members and external providers to clarify missing information and help move cases toward resolution.

Qualifications: • High school diploma or equivalent required; an associate degree is preferred.• At least 1 year of experience in healthcare administration, medical office support, managed care, or prior authorization processing.• Working knowledge of medical terminology and familiarity with ICD-10 and CPT/HCPCS coding concepts.• Understanding of prior authorization procedures, insurance verification, and healthcare benefit review.• Strong data entry skills with a high level of accuracy and the ability to manage multiple tasks at once.• Proficiency with Microsoft Outlook, Word, Excel, and Adobe Acrobat.• Effective customer service and communication skills when interacting with providers and internal teams.• Experience with utilization management systems or related healthcare platforms is preferred but not required.

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Long Beach, CA
onsite
Temporary / Contract
22.8 - 26.4 USD / Hourly
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 will manage prior authorization activity, maintain accurate records, and communicate effectively with providers in a fast-paced environment. Key Responsibilities:• Review and process prior authorization submissions using the designated authorization platform while ensuring each request is handled accurately and efficiently.• Confirm member coverage details, benefit information, and provider network participation before authorization decisions move forward.• Record case updates, communication history, and status changes in a clear and organized manner within the appropriate systems.• Track request timelines for both urgent and routine cases to help maintain compliance with internal standards and regulatory requirements.• Respond to incoming provider inquiries received by phone, fax, or portal and route clinical matters to UM Nurses when needed.• Support daily utilization management activities by prioritizing multiple requests and maintaining consistent turnaround performance.• Coordinate with internal team members and external providers to clarify missing information and help move cases toward resolution.
2026-10-20T00:00:00Z