Utilization Management Coordinator

Job Summary

Utilization Management Coordinator, a contract position requiring remote work, supports clinical teams by performing non-clinical administrative tasks related to pre-service, utilization review, and care coordination.

Key Responsibilities

• Review authorization requests for initial determination and triage for clinical review
• Provide general support including answering phone calls, taking messages, and assisting with problem-solving
• Assist with reporting, data tracking, and organization of information related to care processes

Required Qualifications

• High school diploma or equivalent
• Minimum of 3 years of experience in a healthcare or managed care setting
• Call center experience with the ability to manage a high volume of calls
• Knowledge of CPT and ICD-10 coding is preferred
• Experience with administrative support related to member or provider services