Utilization Review Coordinator

🔥 13 hours ago

🐊 Florida – Remote

infoinfo

💵 $18 - $20 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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Logo of Sedgwick

Sedgwick

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Access, triage, and assign cases for utilization review • Respond to telephone inquiries, provide accurate information, and triage as necessary • Enter demographics and utilization review information into claims or clinical management systems • Maintain data integrity • Obtain necessary information for utilization review processing from internal and external sources according to policies and procedures • Distribute incoming and outgoing correspondence, faxes, and mail • Upload review documents into the paperless system as necessary • Support other units as needed • Perform other duties as assigned • Support the organization's quality programs

🎯 Requirements

• 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 plans to choose from • Two dental plans to choose from • Vision insurance • Tuition reimbursement eligibility • 401(k) plan with 50% matching on contributions up to the first 6% saved • 4 weeks PTO in the first full year • Disability insurance • Life insurance • Employee assistance program • Flexible spending account or health savings account • Other additional voluntary benefits • Work-life balance • Reasonable accommodations when applicable and appropriate

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