Utilization Management Coordinator
Utilization Management Coordinator
Posted on :
27-10-2024
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Job Description
Position: Utilization Management Coord
Location: Baltimore MD #REMOTE (Occasionally required onsite)
Contract Position
Job Description:
- Supports the Utilization Management clinical teams by assisting with nonclinical administrative tasks and responsibilities related to preservice utilization review care coordination and quality of care.
- Education Level: High School Diploma
- 3 years experience in health care claims/service areas or office support.
- Requirred Medical back ground computer skills medical terminology claims and service office support CPT and ICD10 coding
Preferred Qualifications:
Two years experience in health care/managed care setting or previous work experience
Knowledge of CPT and ICD10 coding.
Knowledge Skills and Abilities (KSAs)
- Ability to effectively participate in a multidisciplinary team including internal and external participants. Proficient
- Excellent communication organizational and customer service skills. Proficient
- Knowledge of basic medical terminology and concepts used in managed care. Proficient
- Knowledge of standardized processes and procedures for evaluating medical support operations business practices. Proficient
- Excellent independent judgment and decisionmaking skills consistently demonstrating tact and diplomacy. Proficient
- Ability to pay attention to the minute details of a project or task Proficient
- Experienced in the use of webbased technology and Microsoft Office applications such as Word Excel and Power Point Proficient
ESSENTIAL FUNCTIONS:
- 35% Performs member or provider related administrative support which may include benefit verification authorization creation and management claims inquiries and case documentation.
- 35% Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
- 20% Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls taking messages letters and correspondence researching information and assisting in solving problems.
- 10% Assists with reporting data tracking gathering organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.
Thanks & Regards
LAXMAN
KMM Technologies Inc.
CMMI Level 2 ISO 9001 ISO 20000 ISO 27000 Certified
WOSB SBA 8(A) MDOT MBE & NMSDC MBE
Tel: (240)Email:
Employment Type
Full Time
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