Telecommute Medical Claims Review Coordinator

Job Summary

A managed healthcare and insurance company is filling a position for a Telecommute Medical Claims Review Coordinator.

Individual must be able to fulfill the following responsibilities:

• Researching and resolving UM inventory accordingly to meet productivity and quality standards
• Coordinating initial screening for UM claim reviews through claim queue
• Preparing administrative files for Medical Directors, UM Nurses and Case Managers

Required Skills:

• High School Diploma or GED equivalent
• 2+ years of experience in managed care in Prior Authorization or Claim Review
• Medical Terminology, ICD-9/ICD-10 and CPT knowledge
• Proficient with Medicare processing guidelines, working knowledge of medical contracts