Utilization Management Coordinator

A company is looking for a Utilization Management Coordinator.

Key Responsibilities

Assist the clinical team with administrative tasks related to Utilization Management prior authorizations and appeals

Verify eligibility, process documentation, and manage communication with providers regarding medical records

Document and initiate appeal cases while ensuring compliance with internal and regulatory deadlines

Required Qualifications

1 year of experience as a UM Coordinator in a managed care payer environment preferred

Knowledge of ICD-10, HCPCS codes, and medical terminology required

Strong computer skills with proficiency in Word, Outlook, and other software applications

Ability to prioritize multiple tasks using time management and organizational skills

Experience with DMEPOS and Medicare / Medicaid is a plus