Utilization Review Coordinator

Sedgwick • Cincinnati, OH

125d

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator This is a hybrid position, that requires 2 days in office (Tuesday/Wednesday) at 4445 Lake Forest Drive. Blue Ash, OH 45242.

Requirements

• High School diploma or GED required.
• Two (2) years of administrative experience or equivalent combination of experience and education required.
• Customer service in medical field preferred.
• Workers compensation, disability and/or liability claims processing experience preferred.
• Knowledge of medical and insurance terminology.
• Knowledge of ICD9 and CPT coding.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Detail Oriented.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Responsibilities

• Accesses, triages and assigns cases for utilization review (UR).
• Responds to telephone inquiries providing 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.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Benefits

• Three Medical, and two dental plans to choose from.
• Tuition reimbursement eligible.
• 401K plan that matches 50% on every $ you put in up to the first 6% you save.
• 4 weeks PTO your first full year.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees