Utilization Review Coordinator
$18 - $20 per hourSedgwick
Utilization Review Coordinator
Primary Purpose: To assign utilization review requests; to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment.
Are You An Ideal Candidate? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.
Essential Functions and Responsibilities:
- Accesses, triages and assigns cases for utilization review (UR).
- Responds to telephone inquiries providing 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.
Additional Functions and Responsibilities:
- Performs other duties as assigned.
- Supports the organization's quality program(s).
Qualifications:
Education & Licensing: High School diploma or GED required.
Experience: 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.
Skills & Knowledge:
- 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
Work Environment: When applicable and appropriate, consideration will be given to reasonable accommodations.
Taking Care Of You By:
- We offer a diverse and comprehensive benefits package including:
- Three Medical, and two dental plans to choose from.
- Tuition reimbursement eligible.
- 401K plan that matches 50% on every $ you put in up to the first 6% you save.
- 4 weeks PTO your first full year.
Next Steps:
If your application is selected to advance to the next round, a recruiter will be in touch.
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $18-20.00/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
- ...Utilization Review Coordinator Mountain Youth Academy is nestled in Mountain City, Tennessee which is a short commute from Johnson City, TN, Boone, NC, and Abingdon, VA. We are a 120-bed residential treatment facility and assist in the evaluation, diagnosis, and treatment...SuggestedWork at officeLocal areaShift work
- ...Arcare in Augusta, AR is seeking a Utilization Review Associate to support planning and coordinating Utilization Review duties. The role involves handling HEDIS measures, AWVs, reporting, and collaboration with third-party payers. The position requires a high school diploma...SuggestedHourly payFull timeWork at office
- ...To support clinical staff in a collaborative environment, the full-time Utilization Review Coordinator will manage utilization review requests, verify and enter data into systems, and respond to inquiries while working remotely. Key responsibilities Access, triage, and...SuggestedFull timeWork at officeRemote work
$70k - $80k
...Utilization Review Coordinator Guidelight Health is a cutting-edge behavioral healthcare company dedicated to transforming lives through high-quality PHP (Partial Hospitalization Program) and IOP (Intensive Outpatient Program) services. As a newly launched organization...SuggestedFull timePart timeRemote work- ...Utilization Review Coordinator NeuroPsychiatric Hospital of Indianapolis is looking for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with...SuggestedWork at office
- ...Full-time Utilization Review Coordinator The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in Illinois since 1989. Located in Champaign, Illinois, we provide a secure, nurturing environment...Full timeLocal area
- ...Job Title Provide Utilization Review and Case Management to the Emergency Department population who present with social and or discharge needs which may prevent them from returning to their current environment. Will provide hospital wide Utilization Review and Case...Full timePart time
- ...Utilization Review Coordinator Per Diem Coastal Harbor Health is currently seeking a Utilization Review Coordinator Per Diem to coordinate and direct Utilization Review functions, monitoring the utilization and continuum of services to optimize reimbursement. Coastal...Daily paidTemporary workReliefLocal area
- ...precertification and verification of benefits for incoming patients. Coordinates the utilization management functions of a patient caseload through... ...the interdisciplinary treatment team and performance of reviews, with external review organizations/managed care companies...Local area
- ...Utilization Management Specialist Proactively monitor utilization of services for patients... ...clinical staff. Conduct reviews, in accordance with certification requirements... ...managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement...Work at office
$46k
...Utilization Review Coordinator New Vista Health and Wellness is currently recruiting a Utilization Review Coordinator! The New Vista mission: Inspiring Hope, Restoring Peace of Mind, Healing Lives. At New Vista, our passionate and highly trained team of professionals...Flexible hours- ...Utilization Review Coordinator Energy Plaza - Idaho Falls, ID Overview Position Type: Full Time Job Shift: Any Education Level: High School Travel Percentage: None Category: Health Care Description Mountain View Hospital is looking for a Utilization Review...Full timePart timeReliefShift work
- ...Utilization Review Coordinator Opportunity HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals, who provide service excellence to our patients in a range of inpatient and partial programs...Full timeLocal area
- ...Utilization Review Coordinator Lakeview Health has helped thousands of people detox, recover and remain abstinent from dangerous substances. We strive to be the best in the addiction treatment field through our proven treatment programs, experienced staff, and amenity...
- ...Job Title Assists the utilization review process taking on various tasks including data collection of demographic, claim and medical information; non-medical analysis; and outcomes reporting. Performs routine record keeping tasks. Provide clerical support to the department...
- ...Job Description Job Description The Utilization Review (UR) Coordinator is responsible for coordinating the clinical review process to ensure appropriate utilization of inpatient psychiatric services while maximizing reimbursement through timely authorization, concurrent...
- ...Job Description Job Description Our inpatient behavioral health hospital is seeking a PRN Utilization Review Coordinator. This position is responsible for working with insurance companies and managed care systems for the initial authorization, concurrent and retrospective...Full timeRelief
- ...Job Description Job Description Utilization Review Coordinator Location: Everwell Port St. Lucie Hospital, Inc Position Summary Everwell Port St. Lucie Hospital is seeking a detail-oriented Utilization Review Coordinator to coordinate insurance reviews, monitor...
- ...Job Description Avenues Recovery Center is Now Hiring: Utilization Review Specialists Avenues Recovery Center is a nationwide network... ...authorization, clinical documentation integrity, and continued stay coordination across our network. Position Overview Location:...Full timeTemporary workWork at officeImmediate startFlexible hours
$25 - $38.95 per hour
...services, and intensive outpatient services. Learn more at Coordinates and reviews all medical records, as assigned to caseload. Actively... ...status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work...Full timeWork experience placementLocal area$24 - $29 per hour
...Job Description Job Description Job Title: Utilization Review (UR) Coordinator / Authorization Representative [Clinical Experience Preferred] – Behavioral Health Employment Type: Full-Time Schedule: In-office, Monday through Friday Position Overview...Hourly payFull timeWork at officeLocal areaMonday to Friday- ...Job Description Job Description Assists the utilization review process taking on various tasks including data collection of demographic, claim and medical information; non-medical analysis; and outcomes reporting. Performs routine record keeping tasks. Provide clerical...Temporary work
- ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Full timeRemote work
- ...Description Job Description Job Summary The Supervisor of Utilization Review (UR) oversees the development, implementation, and... ...concurrent reviews, acute care utilization, high-risk cases, care coordination, and discharge planning. The UR Supervisor collaborates...Work at officeRemote work
- ...patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare... ...necessity and appropriateness of healthcare services. Coordinate with healthcare providers, insurance representatives, and case...Part timeRemote work
- ...Seeking a confident and detail-oriented Utilization Review Specialist, the full-time remote position will involve reviewing clinical documentation, managing insurance authorizations, and collaborating with providers to ensure timely care for clients in a behavioral health...Full timeRemote work
$30 - $45 per hour
...opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This...Hourly payContract workRemote work- ...Responsibilities Black Bear Lodge Utilization Management Coordinator Foundations Recovery Network (FRN) is the premier provider of integrated treatment... ...Qualifications Essential Duties and Responsibilities Reviews and understands insurance information provided by the...Work at officeLocal area
- ...Universal Hospital Services Inc. is seeking a UR Coordinator for the Midwest Center for Youth and Families in Kouts, Indiana. This position entails managing treatment activities, conducting clinical screenings, and coordinating with insurance companies. The ideal candidate...
- ...Utilization Management Coordinator Responsibilities Shape the future of behavioral health care throughout the Forest Park community by joining our... ...including but not limited to assigning and scheduling; reviewing and approving documentation and reports; advising and mentoring...
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Review Coordinator. Be the first to apply!
- cosmetic coordinator United States
- iep coordinator United States
- breakdown coordinator United States
- academic success coordinator United States
- delivery coordinator United States
- workforce coordinator United States
- student coordinator United States
- visual merchandising coordinator United States
- contracts coordinator United States
- electrical coordinator United States


