Utilization Review Coordinator

Job Summary

To support clinical staff in a collaborative environment, the full-time Utilization Review Coordinator will assign utilization review requests, verify and enter data into appropriate systems, and respond to inquiries while working remotely.

Key responsibilities

• Accesses, triages, and assigns cases for utilization review
• Enters demographics and utilization review information into claims or clinical management systems, maintaining data integrity
• Obtains necessary information for utilization review processing from internal and external sources

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