Utilization Review Customer Service Representative
Sedgwick
full-time
Posted on:
Location Type: Remote
Location: Tennessee • United States
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Salary
💰 $17 - $18 per hour
Job Level
About the role
- Assist in evaluating the medical necessity, appropriateness and efficiency of the health care services and procedures.
- Answer phones for the utilization review department.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
Requirements
- High school diploma or GED required.
- One (1) year of experience with workers compensation legal and regulatory requirements and quality/managed care concepts or equivalent combination of education and experience required.
- Knowledge of workers compensation claims procedures and state legal and regulatory requirements.
- Good customer service skills.
- Good oral and written communication skills.
- PC literate, including Microsoft Office products.
- Excellent interpersonal skills.
- Good organizational and time management skills.
- Good problem-solving skills.
- Good analytical skills.
- Ability to manage multiple and changing priorities.
- Ability to work in a team environment or independently with little supervision.
- Ability to meet or exceed Performance Competencies.
Benefits
- Three Medical and two dental plans to choose from.
- Tuition reimbursement eligible.
- 401K plan that matches 50% on every $ you put in up to the first 6% you save.
- 4 weeks PTO your first full year.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
workers compensation claims proceduresquality/managed care conceptsmedical necessity evaluationhealth care services evaluation
Soft Skills
customer serviceoral communicationwritten communicationinterpersonal skillsorganizational skillstime managementproblem-solvinganalytical skillsability to manage prioritiesteamwork
Certifications
high school diplomaGED