Referral UM Coordinator Level I

The Referral UM Coordinator Level I provides essential clerical support and assists the clinical team within the Utilization Management department by processing a high volume of prior authorization requests. This role ensures that all orders and referrals align with health plan benefits, validates eligibility and contract status, and escalates exceptions to the clinical team. The coordinator interacts with various stakeholders, including medical directors, healthcare providers, and health plans, to facilitate seamless utilization management services.