Description
By joining Sedgwick, you'll be part of a global organisation that makes a meaningful difference in people's lives.
As a Utilization Review Coordinator, your primary purpose will be to assign utilization review requests, verify and enter data into the appropriate system, and provide general support to clinical staff in a team environment.
Responsibilities:
- Access, triage, and assign cases for utilization review (UR)
- Respond to telephone inquiries, providing accurate information and triage as necessary
- Enter demographics and UR information into claims or clinical management systems, maintaining data integrity
- Obtain necessary information required for UR processing from internal and external sources per policies and procedures
- Distribute incoming and outgoing correspondence, faxes, and mail; upload review documents into paperless systems as necessary
- Support other units as needed
Additional Responsibilities:
- Perform other duties as assigned
- Support the organisation's quality program(s)
Requirements:
- 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
- Workers compensation, disability, and/or liability claims processing experience preferred
Skills and Knowledge:
- Knowledge of medical and insurance terminology
- Knowledge of ICD9 and CPT coding
- Excellent oral and written communication, including presentation skills
- PC literacy, including Microsoft Office products
- Analytical and interpretive skills
- Strong organisational skills
- Detail-oriented
- Good interpersonal skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
Benefits:
- Diverse and comprehensive benefits package, including:
- 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 in your first full year
Salary:
- The range of starting pay for this role is $18-20.00/hr