[Hiring] Utilization Review Coordinator @Sedgwick

Role Description

To assign utilization review requests; to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment.

We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

• Accesses, triages and assigns cases for utilization review (UR).
• Responds to telephone inquiries providing accurate information and triage as necessary.
• Enters demographics and UR information into claims or clinical management system; maintains data integrity.
• Obtains all necessary information required for UR processing from internal and external sources per policies and procedures.
• Distributes incoming and outgoing correspondence, faxes and mail; uploads review documents into paperless system as necessary.
• Supports other units as needed.

Performs other duties as assigned and supports the organization's quality program(s).

Qualifications

• High School diploma or GED required.
• Two (2) years of administrative experience or equivalent combination of experience and education required.
• Customer service in medical field preferred.
• Workers compensation, disability and/or liability claims processing experience preferred.
• Knowledge of medical and insurance terminology.
• Knowledge of ICD9 and CPT coding.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Detail Oriented.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Benefits

• Three Medical, and two dental plans to choose from.
• Tuition reimbursement eligible.
• 401K plan that matches 50% on every $ you put in up to the first 6% you save.
• 4 weeks PTO your first full year.