Non-Clinical UR Coordinator

Overview:

The Non-Clinical Administrator Reviewer is responsible for supporting the Utilization Review (UR) process by performing administrative and data-related tasks. This role focuses on ensuring that requests are complete, accurately documented and properly routed, without performing any clinical evaluation or interpretation of medical information.

Duties:

• Conduct initial screening of utilization review requests for completeness and accuracy of submitted information
• Review service requests to ensure all required non-clinical documentation is present;
• Collect, organize and transfer non-clinical data into internal systems;
• Input and maintain accurate data in Medata’s proprietary UR system;
• Assist in gathering data without performing a clinical analysis
• Ensure all assigned tasks are completed within established timelines and service level agreements.
• Coordinate and communicate with Initial Clinical Reviewers and other internal teams for case processing
• Maintain confidentiality and comply with data privacy and security standards
• Perform other administrative duties as assigned based upon business needs

Experience, Training, and Education:

• Graduate of a college level degree program required, preferably in a health sciences field of study
• Previous experience in administrative support, data entry or back-office operations preferred
• Experience in Utilization Management, healthcare administration or insurance processes- preferred
• Must be familiar with basic Microsoft Office applications, such as Word and Excel.
• Experience should include working in fast-paced work environments.
• Must be able to maintain confidentiality.

Knowledge, Skills and Abilities:

Good organizational and time management skills. High level of integrity and ability to maintain confidentiality of sensitive information.