About the role
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 PRNPRIMARY PURPOSE: To assign utilization review requests; to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Accesses, triages and assigns cases for utilization review (UR).
- Responds to telephone inquiries proving 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.ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).QUALIFICATIONS
Education & Licensing
High School diploma or GED required.
Experience 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.