Utilization Review Coordinator

Utilization Review Coordinator

Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?

• A stable and consistent work environment in an office and/or virtual setting
• A training program to learn how to help employees and customers from some of the world's most reputable brands
• An assigned mentor and manager who will guide you on your career journey
• Career development and promotional growth opportunities through increasing responsibilities
• A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs

Primary Purpose Of The Role: To provide excellent customer service and internal support to an assigned team.

Ideal candidates will thrive in a collaborative team environment, show motivation and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.

Essential Responsibilities May Include:

• Accesses, triages and assigns cases for utilization review (UR).
• Responds to telephone inquiries proving 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.

Qualifications:

• Education & Licensing: High school diploma or GED required
• Skills: Strong oral and written communication, computer literate including Microsoft Office, organizational skills required
• Experience: Clerical or customer service experience or equivalent combination of education and experience preferred

Taking Care Of You:

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment. [IF APPLICABLE]
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work environment requirements for entry-level opportunities include:

Physical: Computer keyboarding

Auditory/visual: Hearing, vision and talking

Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

Next Steps: If your application is selected to advance to the next round, a recruiter will be in touch.

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.