Terms of Employment
- Contract, 12 Months
- This position is primarily remote. With that said, candidates must reside in Maryland for onsite training and “All Hands” meetings.
- The schedule is Monday – Friday, 8:15 AM – 5:00 PM (Eastern) with an hour-break.
Overview
Our client is looking for a Utilization Management Coordinator who can support the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care. The Utilization Management Coordinator will be working in a team environment, responsible for entering, routing, and updating patient cases that are lacking a discharge date using a care management software platform. The Utilization Management Coordinator will receive cases from the Manager of Clinical Support on a daily basis, review the information for discharge date information, and contact provider offices and/or facilities to gather this information if it is missing in an effort to close out the cases so claims can be fully processed.
Required Skills & Experience
- High School Diploma and 3+ years of experience in an administrative position in the healthcare / health insurance industries.
- Strong skills in data entry, to include managing patient information.
- Ability to effectively participate in a multi-disciplinary team including internal and external participants.
- Excellent communication, organizational, and customer service skills.
- Knowledge of basic medical terminology and concepts used in managed care.
- Knowledge of standardized processes and procedures for evaluating medical support operations business practices.
- Excellent independent judgment and decision-making skills, consistently demonstrating tact and diplomacy.
- Ability to pay attention to the minute details of a project or task.
- Microsoft Office applications such as Word, Excel, Outlook and Teams.
Preferred Skills & Experience
- Knowledge of healthcare claims.
- Knowledge of CPT and ICD-10 coding.
- Experience using a claims management platform such as GuidingCare.
- Experience using CareManager.
- Experience using Facets solutions.
- Experience using NASCO solutions.
nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.
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