Utilization Management Coordinator
System One
Baltimore, MD(remote)
JOB DETAILS
SALARY
$24.67–$25 Per Hour
SKILLS
Administrative Skills, Business Practices, Communication Skills, Cross-Functional, Current Procedural Terminology (CPT), Customer Support/Service, Data Collection, Detail Oriented, Documentation, Healthcare, ICD-10, Internet Technology, Managed Care, Medical Office Administration, Medical Terminology, Medical Treatment, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft Word, Operational Audit, Organizational Skills, Outsourcing, Problem Solving Skills, Quality of Care, Service Delivery, Technical Support, Telephone Skills, Utilization Management
LOCATION
Baltimore, MD(remote)
POSTED
2 days ago
Location: Baltimore, MD(remote, but must live in the DMV area)
Type: Contract
Compensation: $25 hourly
Contractor Work Model: Remote
PURPOSE:
Supports 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. (this position is remote)
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.
Qualifications
Education Level: High School Diploma
Experience:
- 3 years experience in health care claims/service areas or office support.
- 2 years experience in health care/managed care setting or previous work experience within division
- Intermediate knowledge of CPT and ICD-10 coding (current)
- Additional Skills: Guiding Care, NiceXOne, Facets
- Ability to effectively participate in a multi-disciplinary 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 decision-making 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 web-based technology and Microsoft Office applications such as Word, Excel, and Power Point, Proficient
System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.
System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.
#M-PJ1
#LI-PJ1
#DI-PJ1
Ref: #851-Rockville-S1
About the Company
S
System One
Every day, System One focuses on services and solutions that require a high degree of specialization, in-demand technical skills, and large-scale operational expertise. We are essential partners to those on the front lines of our nation’s most critical infrastructure, technology, and life sciences initiatives.
Founded more than 40 years ago as a staffing partner to the engineering industry, today System One is a diversified organization operating in over 50 locations and putting more than 9,000 people to work in the United States, Canada, and the United Kingdom.
COMPANY SIZE
2,500 to 4,999 employeesINDUSTRY
Staffing/Employment Agencies
WEBSITE
https://systemone.com