Utilization Review Coordinator
Permanent - Full Time $18.00 - $20.00 / hourJob Overview
Our Story
Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.
We are looking for a Utilization Review Coordinator to provide Utilization Review administrative assistance to nurses, along with providing clerical support per guidelines for Initial Requests for referrals for specialists.
Key Responsibilities
- Follow workflow expected of UR Coordinator according to company and client protocols and production standards:
- Coordinate scheduling of specialist referrals that have been approved by the UR Specialists.
- Follow Rapid Response protocol established by client to authorize initial PT, initial diagnostics and initial referrals to a specialist upon receipt of referral on all new claims.
- Document initial actions in Corrus using correct grammar, spelling, and sentence structure.
- May act as back-up assistance for Triage Department and CMA Department.
- Perform other duties as needed.
Skills, knowledge & expertise
- High school diploma.
- A minimum of one year of medical terminology/medical office experience.
- Have a working knowledge of appropriate state’s Workers’ Compensation system and the statutes.
- Medical terminology knowledge.
- Experience dealing with medical provider offices.
- Data entry proficiency and computer skills –Word, Excel.
- Excellent organizational skills.
- Detail orientated and motivated.
- Ability to work in fast-paced environment and utilize critical thinking skills to ensure proactive outcomes.
- Ability to effectively operate a personal computer and related claims and business software.
- Good communication skills, both oral and written.
- Team player.
- Good attendance.
- Good customer service skills.