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)