Utilization Management Specialist

Job Title

Coordinates entire intake process as necessary with referral sources, providers, patients, and internal team members. May perform all or some of the following functions: Intake, Referral, Evaluation, and/or Documentation. Processes thorough, accurate and complete cases and new orders based upon information provided by the requester. Effectively communicates referrals and patient information to all departments.

RESPONSIBILITIES:

• Basic knowledge of medical terminology.
• Excellent time-management and multi-tasking skills.
• Comfortable with and be able to thrive in an ever-changing environment.
• Demonstrates a high degree of customer focus and attention to service.
• Strong computer skills.
• Basic proficiency with Microsoft Word and Excel.
• Must be approachable, polite and have an impeccable work ethic, supporting the company's culture.
• Excellent communication skills, both written and verbal.
• Experience and understanding of medical coding (ICD-9 codes, CPT/HCPCS, etc.).
• Knowledge of Microsoft Access or other databases.
• Previous intake experience.

WORK EXPERIENCE: Administrative Support, PBM (Pharmacy Benefit Management)

EDUCATION: High School Diploma or GED (Required)