Utilization Review & Data Coordination Specialist

Sedgwick; United States; On-site; USD 25,000 - 28,000; Full time

Benefits offered by this job

Three Medical, and two dental plans to

Tuition reimbursement eligible.

401K plan that matches 50% on every $

4 weeks PTO your first full year.

Job summary

Sedgwick is seeking an Utilization Review Coordinator to assign UR requests, verify data, and provide support to clinical staff in a collaborative team environment.

Two years of administrative experience in a medical setting are preferred, along with knowledge of medical terminology and ICD9/CPT coding. Proficiency in Microsoft Office is expected and Sedgwick emphasizes care, balance, and opportunity.

Qualifications

• 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

Responsibilities

• Accesses, triages and assigns cases for utilization review (UR).
• Responds to telephone inquiries proving 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

Knowledge of medical and insurance тер

Education

High School diploma or GED

Tools

ICD9 and CPT coding

Microsoft Office

Job description

Sedgwick is seeking an Utilization Review Coordinator to assign UR requests, verify data, and provide support to clinical staff in a collaborative team environment.

Two years of administrative experience in a medical setting are preferred, along with knowledge of medical terminology and ICD9/CPT coding. Proficiency in Microsoft Office is expected and Sedgwick emphasizes care, balance, and opportunity.