Remote Utilization Management Coordinator I

Location: Washington

Compensation: To Be Discussed

Staff Reviewed: Wed, Jun 09, 2021

This job expires in: 18 days

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

Job Summary

A non-profit managed care organization has an open position for a Remote Utilization Management Coordinator I.

Core Responsibilities of this position include:

  • Performing data entry for all referral, prior authorizations & hospital notifications
  • Utilizing knowledge to determine appropriate CPT, HCPC, ICD-10 codes using CMS, NCQA and HCA criteria
  • Researching & validating benefit & prior authorization requirements to determine appropriate course of action

Skills and Requirements Include:

  • Associates degree or an equivalent combination of education and highly relevant experience required
  • Experience in a Healthcare setting preferred
  • One year customer service experience preferred
  • Experience in Managed Care preferred
  • Knowledge of medical terminology and healthcare process preferred

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