Utilization Review Coordinator

Sedgwick

Utilization Review Coordinator at Sedgwick assigning utilization review requests and providing support for clinical staff. Managing data integrity and processing client inquiries in a team environment.

Posted 7/23/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-Level💰 $18 - $20 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in utilization review processes, including data entry and management, while maintaining strong organizational and analytical skills. Proficient in medical terminology and coding, with a focus on delivering excellent customer service in a clinical environment.

Highest-signal resume keywords

Utilization Review ProcessingICD9 And CPT CodingData Entry And ManagementCustomer Service In Medical FieldMicrosoft Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ReviewData EntryICD9 CodingCPT CodingClaims ProcessingMedical TerminologyAnalytical SkillsDetail Orientation

Soft Skills

Excellent CommunicationInterpersonal SkillsOrganizational SkillsTeam Collaboration

Tools & Technologies

Clinical Management SystemPaperless SystemMicrosoft Office

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Workers CompensationDisability ClaimsLiability Claims

About the role

Key responsibilities & impact

Assign utilization review requests.
Verify and enter data in appropriate system(s).
Provide general support to clinical staff in a team environment.
Access, triage and assign cases for utilization review (UR).
Respond to telephone inquiries proving accurate information and triage as necessary.
Enter demographics and UR information into claims or clinical management system; maintain data integrity.
Obtain all necessary information required for UR processing from internal and external sources per policies and procedures.
Distribute incoming and outgoing correspondence, faxes and mail; upload review documents into paperless system as necessary.
Support other units as needed.

Requirements

What you’ll need

High School diploma or GED required.
Two (2) years of administrative experience or equivalent combination of experience and education required.
Customer service in medical field preferred.
Workers compensation, disability and/or liability claims processing experience preferred.
Knowledge of medical and insurance terminology.
Knowledge of ICD9 and CPT coding.
Excellent oral and written communication, including presentation skills.
PC literate, including Microsoft Office products.
Analytical and interpretive skills.
Strong organizational skills.
Detail Oriented.
Good interpersonal skills.
Ability to work in a team environment.
Ability to meet or exceed Performance Competencies.

Benefits

Comp & perks

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.