Utilization Review Resource Specialist

CoxHealth

Job Overview

Location

Remote Missouri

Job Type

Full-time

Full Job Description

📋 Description

• The Utilization Review Resource Specialist plays a critical role in ensuring accurate insurance authorization documentation, supporting timely patient access to care and compliance with payer requirements within CoxHealth’s Utilization Review department.
• Day-to-day responsibilities include responding to requests from the Utilization Review and Central Access departments to confirm and accurately document insurance authorization information, entering data into computer systems, and facilitating communication between clinical and administrative teams to support utilization management processes.
• CoxHealth is a leading healthcare system serving 25 counties across southwest Missouri and northern Arkansas, operating six hospitals, five emergency rooms, and over 80 clinics, recognized nationally for workplace excellence including multiple Modern Healthcare Best Places to Work awards and Forbes’ Best Employers for New Grads.
• In this role, the individual will develop expertise in healthcare authorization processes, medical terminology, insurance verification, and electronic health record systems, while building strong analytical, communication, and organizational skills applicable to advancement in healthcare administration or utilization management.

🎯 Requirements

• High school diploma or equivalent (required)
• One year of hospital or healthcare experience (preferred)
• Strong written and verbal communication skills
• Strong analytical and problem-solving abilities
• Ability to maintain organization in a dynamic environment
• Proficiency with Windows-based systems, Microsoft Office, email, and willingness to learn required healthcare applications

🏖️ Benefits

• Medical, vision, dental, and retirement plans with employer match (for 20+ hours/week)
• Recognition as a top employer including Modern Healthcare’s Best Places to Work (five times), Newsweek’s Greatest Workplaces in Healthcare (2025, 2026), and Forbes’ Best Employers for New Grads
• Access to a comprehensive benefits package via CoxHealth’s employee benefits portal

Skills & Technologies

Remote

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CoxHealth

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About CoxHealth

CoxHealth is a leading integrated health system serving southwest Missouri. It comprises multiple hospitals, including Cox South, Cox Branson, and Cox Monett, along with numerous outpatient centers, physician clinics, and specialized care facilities. The organization is committed to providing comprehensive, high-quality healthcare services across a wide range of medical disciplines. CoxHealth focuses on patient-centered care, innovation in medical technology, and community well-being. It plays a vital role in the region's healthcare landscape, offering advanced treatments, preventive services, and emergency care. The system is dedicated to improving the health of the communities it serves through accessible and compassionate medical expertise.

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