Remote Utilization Review Coordinator

Sedgwick; Tallahassee (FL); Remote; USD 25,000 - 28,000; Full time

Benefits offered by this job

Medical plans

Dental plans

401(k) plan

PTO – 4 weeks

Tuition reimbursement

Job summary

Sedgwick is seeking an Utilization Review Coordinator to assign UR requests, verify data, and support clinical staff in a collaborative team. The role involves data entry, case triage, and responding to inquiries to ensure accurate UR processing.

The ideal candidate brings administrative experience in a medical environment, knowledge of ICD9/CPT, and strong communication and organizational skills. This telecommuter position offers comprehensive benefits and a supportive culture.

Qualifications

• High School diploma or GED required.
• Two years of administrative experience; customer service in medical field preferred.
• Workers compensation, disability and/or liability claims processing experience preferred.
• Knowledge of ICD9 and CPT coding; familiarity with medical terminology.

Responsibilities

• Accesses, triages and assigns cases for utilization review (UR).
• Responds to telephone inquiries with 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.
• Supports the organization’s quality program(s).

Skills

Medical terminology

Insurance terminology

ICD9/CPT coding

Communication skills

PC literacy

Analytical skills

Organizational skills

Detail oriented

Interpersonal skills

Team player

Education

HS diploma or GED

Job description

Sedgwick is seeking an Utilization Review Coordinator to assign UR requests, verify data, and support clinical staff in a collaborative team. The role involves data entry, case triage, and responding to inquiries to ensure accurate UR processing.

The ideal candidate brings administrative experience in a medical environment, knowledge of ICD9/CPT, and strong communication and organizational skills. This telecommuter position offers comprehensive benefits and a supportive culture.