3 years experience in health care claims/service areas or office support
Two years’ experience in health care/managed care setting or previous work experience within division
Knowledge of CPT and ICD-10 coding
Requirements:
Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks.
Performs member or provider related administrative support including benefit verification and authorization creation.
Reviews authorization requests for initial determination and/or triages for clinical review.
Provides general support and coordination services for the department, including answering calls and researching information.
Job description
Our Client, a Health Insurance company, is looking for a Utilization Management Coordinator to work remotely.
Responsibilities:
Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care.
Performs member or provider related administrative support which may include benefit verification, authorization creation and management, claims inquiries and case documentation.
Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.
Requirements:
Education Level: High School Diploma
Experience: 3 years experience in health care claims/service areas or office support.
Preferred Qualifications Two years’ experience in health care/managed care setting or previous work experience within division
Knowledge of CPT and ICD-10 coding.
Experienced in the use of web-based technology and Microsoft Office applications such as Word, Excel, and Power Point
