Remote Health Services Utilization Coordinator

Ampcus, Inc; Reston (VA); On-site; USD 25,000 - 41,000; Full time

Job summary

Ampcus Inc. is seeking a highly motivated candidate to join our Utilization Management team on a 3-month contract.

This remote position supports non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care within federal health programs. You will handle authorization creation and management, benefit verification, and inquiries, while coordinating with multidisciplinary teams.

Qualifications

• High School Diploma is required.
• 3 years of experience in health care claims/service areas or office support.
• Knowledge of CPT and ICD-10 coding.
• Experience in health care/managed care setting preferred.
• Experience with web-based technology and MS Office.

Responsibilities

• 35% Performs member or provider-related administrative support including benefit verification, authorization creation and management, claims inquiries, and case documentation.
• 35% Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
• 20% Provides general support and coordination services for the department including answering calls, taking messages, researching information, and solving problems.
• 10% Assists with reporting, data tracking, gathering, organization, and dissemination of information such as Continuity of Care and peer reviews.

Skills

Communication skills

Organizational skills

Customer service

Attention to detail

Medical terminology

Independent judgment

MS Office

Web-based technology

Education

High School Diploma

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Ampcus Inc. is seeking a highly motivated candidate to join our Utilization Management team on a 3-month contract.

This remote position supports non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care within federal health programs. You will handle authorization creation and management, benefit verification, and inquiries, while coordinating with multidisciplinary teams.