Utilization Management Coordinator

Utilization Management Coordinator

ALTA IT Services is staffing a contract to hire opportunity for a Utilization Management Coordinator to support a leading health insurance customer. The individual will support the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care. Commercial - phone and fax: 35 calls in queue at any time Must have Call Center experience Duties:

• Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
• Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
• Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.
• Performs member or provider related administrative support.

Preferred Qualifications Two years' experience in health care/managed care setting or previous work experience within division Knowledge of CPT and ICD-10 coding.