Job Title: Utilization Management Coordinator
Location: Must live in D.C., VA or MD per client requirement

Type: Contract
Compensation: $24/HR
Contractor Work Model: 100% Remote


ALTA IT Services is staffing a contract to hire opportunity for a Utilization Management Coordinator to support a leading health insurance customer. The individual will supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care.

Commercial - phone and fax: 35 calls in queue at any time
Must have Call Center experience


Duties:

• Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
• Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
• Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.
• Performs member or provider related administrative support.

Preferred Qualifications
Two years’ experience in health care/managed care setting or previous work experience within division
Knowledge of CPT and ICD-10 coding.


System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. 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.


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Ref: #851-Rockville-S1