Utilization Review Coordinator – Data-Driven Support

Sedgwick Claims Management Services Ltd; Florida; On-site; USD 25,000 - 28,000; Full time

Job summary

Sedgwick is hiring an Utilization Review Coordinator in the United States. You will assign UR requests, verify data in the claims or clinical management systems, and provide support to clinical staff in a collaborative team environment.

The ideal candidate has two years of administrative experience in a medical setting, knowledge of medical terminology, and proficiency with ICD9/CPT coding and Microsoft Office.

Qualifications

• High School diploma or GED required.
• Two years of administrative experience or equivalent.
• Customer service in medical field preferred.
• Workers' compensation, disability and/or liability claims processing experience preferred.

Responsibilities

• Assigns utilization review cases and triages them within established procedures.
• Responds to telephone inquiries with accurate information and triages as needed.
• Enters demographics and UR information into claims or clinical management systems; maintains data integrity.
• Obtains all necessary information for UR processing from internal and external sources per policies.
• Distributes incoming and outgoing correspondence and uploads review documents into the paperless system.
• Supports other units as needed and contributes to the quality program.

Skills

Medical terminology

Insurance terminology

ICD9 coding

CPT coding

Communication skills

Microsoft Office

Data entry

Education

High School diploma or GED

Tools

Office software

Job description

Sedgwick is hiring an Utilization Review Coordinator in the United States. You will assign UR requests, verify data in the claims or clinical management systems, and provide support to clinical staff in a collaborative team environment.

The ideal candidate has two years of administrative experience in a medical setting, knowledge of medical terminology, and proficiency with ICD9/CPT coding and Microsoft Office.