Utilization Management Coordinator

Job Summary

Detail-oriented and organized, the full-time remote Utilization Management Coordinator will assist the clinical team by processing clinical referrals, verifying eligibility, and entering pre-service requests using ICD 10 and CPT coding while working on a Pacific Time schedule.

Key responsibilities

• Monitor fax folders and verify eligibility and benefit coverage for requested services
• Enter pre-service requests and document the referral process within the referral system
• Assist with correspondence related to requests and maintain documentation of expedited requests

Required qualifications

• Minimum of 1 year experience in a medical setting with knowledge of ICD10, CPT codes, and referral systems
• High school diploma or GED, or equivalent combination of education and experience
• Proficiency in Microsoft Office and ability to type a minimum of 50 words per minute
• Bilingual in English and Spanish preferred
• Experience with the application of UM criteria and familiarity with medical terminology