Utilization Management Coordinator

Job Summary

Utilization Management Coordinator provides full-time administrative support to the Utilization Management Team by efficiently handling document intake, review, and processing to enhance departmental effectiveness.

Key Responsibilities

• Prepare and review inbound faxes for accurate document classification
• Monitor turnaround times and manage the failed fax dashboard for effective communication
• Respond to clinician inquiries and assist with additional administrative tasks as needed

Required Qualifications

• High school diploma or GED
• 1 - 3 years of experience in a population management or managed care setting
• Basic knowledge of medical records and ability to verify member details
• Familiarity with health insurance lines of business
• Working knowledge of medical coding systems including CPT/HCPCS codes