Utilization Review Coordinator
Location
Tennessee
Posted
5 days ago
Salary
0
Seniority
Mid Level
Job Description
Utilization Review Coordinator
Sedgwick
• Assign utilization review requests • Verify and enter data in appropriate system(s) • Provide general support to clinical staff in a team environment • Access, triage, and assign cases for utilization review (UR) • Respond to telephone inquiries proving accurate information and triage as necessary • Enter demographics and UR information into claims or clinical management system; maintain data integrity • Obtain all necessary information required for UR processing from internal and external sources per policies and procedures • Distribute incoming and outgoing correspondence, faxes and mail; upload review documents into paperless system as necessary • Support other units as needed
Job Requirements
- High School diploma or GED required
- Two (2) years of administrative experience or equivalent combination of experience and education required
- Customer service in medical field preferred
- Workers compensation, disability and/or liability claims processing experience preferred
- Knowledge of medical and insurance terminology
- Knowledge of ICD9 and CPT coding
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Detail Oriented
- Good interpersonal skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
Benefits
- Sedgwick’s caring counts® commitment
- Grow your career with us
- Work-life balance
- Support from a caring culture
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