Utilization Review Coordinator

Location

United States

Posted

5 days ago

Salary

$18 - $20 / hour

Seniority

Mid Level

High School2 yrs expEnglish

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 providing 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

  • Three Medical and two dental plans to choose from.
  • Tuition reimbursement eligible.
  • 401K plan that matches 50% on every $ you put in up to the first 6% you save.
  • 4 weeks PTO your first full year.

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