Utilization Management Coordinator-w2 at nTech Herndon, Virginia

Utilization Management Coordinator

nTech Workforce has an immediate Utilization Management Coordinator

Terms of Employment:

• Contract, Three Months (Likely Extension)
• This position is 100% remote. Candidates must reside in MD, DC, or VA.
• Hours: 8:30 AM - 5:00 PM EST.

Overview:

• Work within the Government Programs division to support Maryland Medicaid and Medicare members. You will handle a mix of fax processing and provider phone inquiries to ensure authorizations are created accurately and timely. You will...
• Process faxes and enter medical authorizations for Medicaid/Medicare lines of business.
• Handle incoming provider calls regarding authorization status.
• Distinguish between and utilize CPT, ICD-10, and HCPCS codes for data entry.
• Update patient cases in GuidingCare to ensure claims can be fully processed.

Required Qualifications:

• 3+ years of healthcare/health insurance administrative experience.
• 2+ years of experience with CPT and ICD-10 coding.
• Comfort using online phone systems (Nice CXone).

Preferred Qualifications:

• Previous experience with Medicare or Medicaid programs.
• Experience with GuidingCare or Facets.

Benefits Information:

• Medical Insurance; Vision Insurance; Dental Insurance
• 401K Retirement Plan (Discretionary Match Offered)
• Ancillary Coverage (Life, AD&D, Short Term / Long Term Disability)
• Employee Referral Bonus
• Bi-Weekly Direct Deposit
• Note: As a contingent worker with nTech, you'll be paid for all approved hours worked; paid time off and paid holidays are not provided.

nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.