Utilization Review Coordinator

Job Summary

To support clinical operations, the full-time Utilization Review Coordinator will manage utilization review requests, verify and enter data into systems, and provide general support to clinical staff in a remote environment.

Key responsibilities

• Accesses, triages, and assigns cases for utilization review
• Responds to telephone inquiries and provides accurate information as necessary
• Enters demographics and utilization review information into claims or clinical management systems while maintaining data integrity

Required qualifications

• High School diploma or GED required
• Two years of administrative experience or equivalent combination of experience and education required
• Customer service experience in the medical field preferred
• Knowledge of medical and insurance terminology, including ICD9 and CPT coding
• Proficiency in Microsoft Office products