What are the responsibilities and job description for the Utilization Management Coordinator II position at Progressive Technology Solutions?
Job Title: Utilization Management Coordinator II
Location: 100% Remote (Must be local to DMV area)
Job Overview:
We are seeking a detail-oriented and proactive Utilization Management Coordinator to join our team. This role supports the Utilization Management clinical teams by handling non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care. The ideal candidate will have experience in healthcare claims or office support, strong organizational skills, and the ability to work effectively in a remote environment.
Key Responsibilities:
- Member and Provider Support (35%) – Perform administrative support, including benefit verification, authorization management, claims inquiries, and case documentation.
- Authorization Review (35%) – Review authorization requests for initial determination and triage for clinical review and resolution.
- General Department Support (20%) – Answer and respond to telephone calls, take messages, draft correspondence, research information, and assist in problem-solving.
- Reporting & Data Tracking (10%) – Assist with reporting, data tracking, gathering, organizing, and disseminating information, including Continuity of Care processes and Peer-to-Peer review tracking.
Qualifications:
- Education: High School Diploma or equivalent.
- Experience: 3 years of experience in healthcare claims, service areas, or office support.
- Preferred Experience:
- 2 years of experience in a healthcare/managed care setting.
- Knowledge of CPT and ICD-10 coding.
Required Skills:
- Strong ability to work within a multi-disciplinary team, both internally and externally.
- Excellent communication, organizational, and customer service skills.
- Proficiency in medical terminology and managed care concepts.
- Strong independent judgment and decision-making abilities, with demonstrated tact and diplomacy.
- High attention to detail and accuracy.
- Proficiency in Microsoft Office applications (Word, Excel, PowerPoint) and web-based technology.
44673
Job Type: Contract
Pay: $18.00 - $22.00 per hour
Expected hours: 40 per week
Schedule:
- 8 hour shift
Work Location: Remote
Salary : $18 - $22
