Utilization Mgmt Coord I

Job Title: Utilization Mgmt. Coord. I

Client: Health Care Industry

Duration: 3 Months

Location: Owings Mills Maryland 21117

Purpose:

• Support Utilization Management clinical teams with nonclinical administrative tasks related to preservice utilization review care coordination and quality of care.

Essential Functions:

• 35% Perform member or provider related administrative support (e.g. benefit verification authorization management claims inquiries).
• 35% Review authorization requests and triage for clinical review.
• 20% Provide general departmental support (e.g. answering calls correspondence research problemsolving).
• 10% Assist with reporting data tracking and organization of information (e.g. Continuity of Care Peer to Peer reviews).

Qualifications:

• Education Level: High School Diploma
• Experience: 3 years in health care claims/service areas or office support.

Preferred Qualifications:

• 2 years in health care/managed care setting or divisional experience.
• Knowledge of CPT and ICD10 coding.

Knowledge Skills and Abilities (KSAs):

• Ability to participate effectively in multidisciplinary teams.
• Excellent communication organizational and customer service skills.
• Knowledge of basic medical terminology and managed care concepts.
• Familiarity with standardized processes for evaluating medical support operations.
• Strong independent judgment decisionmaking tact and diplomacy.
• Attention to detail.
• Proficient in webbased technology and Microsoft Office applications (Word Excel PowerPoint).

Additional Requirements:

• Must disclose any debarment exclusion or other eligibility events related to Federal health care programs.
• Ability to work in a fastpaced environment with changing priorities and deadlines.
• Effective handling of multiple customer service demands with a focus on service excellence.
• Strong communication and customer service skills even with challenging customers.