Utilization Management Specialist

Corewell Health

Full-time other-general
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Location
Southfield, MI, United States
Posted
July 27, 2026

Job Description

Job Summary

Under general direction, assists in the provision of the highest service level possible to patients/customers to ensure their satisfaction. Participates in activities with third party payors in order to maximize reimbursement.

Essential Functions

+ Understands and accesses insurance websites. Completes required duties as defined for specific payers to obtain authorization numbers for payment.

+ Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with outpatient or inpatient status.

+ Utilizes electronic medical record work queues that support Utilization Management functions.

+ Answers incoming calls or places outbound calls with appropriate communication skills. Triages all calls to the appropriate person for resolution and action or completes appropriate follow-up.

+ Problem ...