Utilization Review Coordinator

Job Summary

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

Key responsibilities

• Accesses, triages, and assigns cases for utilization review
• Enters demographics and UR information into claims or clinical management systems, ensuring data integrity
• Distributes incoming and outgoing correspondence and uploads review documents into a paperless system as necessary

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