Utilization Review Coordinator

🔥 11 minutes ago

🇺🇸 United States – Remote

💵 $18 - $20 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏢 Enterprise

📋 Compliance

Insurance • Enterprise • Compliance

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

• Assign utilization review requests. • Verify and enter data in appropriate system(s). • Provide general support to clinical staff in a team environment. • 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 system; maintain data integrity. • Obtain all 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 system as necessary. • Support other units as needed.

🎯 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 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.