[Hiring] Utilization Review Coordinator @Davies

Role Description

We are looking for a Utilization Review Coordinator to provide Utilization Review administrative assistance to nurses, along with providing clerical support per guidelines for Initial Requests for referrals for specialists.

• Follow workflow expected of UR Coordinator according to company and client protocols and production standards.
• Coordinate scheduling of specialist referrals that have been approved by the UR Specialists.
• Follow Rapid Response protocol established by client to authorize initial PT, initial diagnostics and initial referrals to a specialist upon receipt of referral on all new claims.
• Document initial actions in Corrus using correct grammar, spelling, and sentence structure.
• May act as back-up assistance for Triage Department and CMA Department.
• Perform other duties as needed.

Qualifications

• High school diploma.
• A minimum of one year of medical terminology/medical office experience.
• Have a working knowledge of appropriate state’s Workers’ Compensation system and the statutes.
• Medical terminology knowledge.
• Experience dealing with medical provider offices.
• Data entry proficiency and computer skills – Word, Excel.
• Excellent organizational skills.
• Detail oriented and motivated.
• Ability to work in fast-paced environment and utilize critical thinking skills to ensure proactive outcomes.
• Ability to effectively operate a personal computer and related claims and business software.
• Good communication skills, both oral and written.
• Team player.
• Good attendance.
• Good customer service skills.

Benefits

• Medical, dental, and vision plans to support your health and that of your family.
• A 401(k) plan with employer matching.
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees.
• Paid holidays.
• Life insurance and short-term and long-term disability coverage.
• Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location.
• Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.