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Requisition Number 19-0125
Post Date 7/26/2019
Title Utilization Review Referral Coordinator
City Birmingham
State AL
Description Seeking Admins with experience in Insurance!

The Utilization Review Referral Coordinator is responsible for answering phone calls and responding to faxed requests from providers for services that require prior authorization. The Utilization Review Referral Coordinator reviews requests for medical necessity using evidence-based criteria or internal guidelines while maintaining compliance with departmental and federal regulations.
Requirements REQUIRED:
• High school diploma or GED
• 1 year experience in an insurance, private physician, hospital setting, or ancillary vendor’s office setting
• Basic knowledge of medical terminology
• Ability to research, read, and interpret health plan or governmental contracts, and medical policy guidelines
• Ability to work under pressure to meet deadlines with minimal supervision
• Basic computer and data entry skills
• Demonstrate excellent customer service skills through written and verbal communication
• Ability to work independently and as a member of the team
• Demonstrate strong organizational and time management skills
• Associate’s Degree
• Relevant customer service or call center experience
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An Equal Opportunity Employer