Utilization Management Coordinator
Not Disclosed•ContractorRemote
location_on613, North Eutaw Street, Mount Vernon, Baltimore, Maryland, 21201, United States
ALTA IT Services, a subsidiary of System One, is a leader in delivering outsourced services and workforce solutions across North America. We partner with clients to help them get work done more efficiently and economically without compromising quality. This role supports a leading health insurance customer within our network.
We are staffing a contract-to-hire opportunity for a Utilization Management Coordinator to support clinical teams in a 100% remote capacity. The ideal candidate must reside in D.C., Virginia, or Maryland. This position serves as a vital bridge for non-clinical administrative tasks related to pre-service authorization, utilization review, care coordination, and quality of care.
In this role, you will manage a high-volume commercial phone queue, handling approximately 35 calls at any given time. You will review authorization requests for initial determinations, triage cases for clinical review, and resolve issues. Your day will involve providing general departmental support by answering calls, managing correspondence, researching information, and assisting with problem-solving. Additionally, you will assist with reporting and data tracking, including the Continuity of Care process and Peer-to-Peer review tracking, while performing administrative support for members and providers.
This is a contract-to-hire position. Qualified candidates with prior call center experience and knowledge of CPT and ICD-10 coding are encouraged to apply.
System One and its subsidiaries are Equal Opportunity Employers. 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.
Work model: Remote
613, North Eutaw Street, Mount Vernon, Baltimore, Maryland, 21201, United States
Baltimore, Maryland
Two years' experience in health care/managed care setting or previous work experience within division. Knowledge of CPT and ICD-10 coding.
