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
