Utilization Management Coordinator

Job summary

Baltimore

Medical Coding

Work model

Fully remote

Only US

2 months ago

Job description

Utilization Management Coordinator

Location: Baltimore, MD 21224
Duration: 3 Months Contract

Terms of Employment

3-Month Contract (Straight Temp Assignment); 100% Remote (Must work on EST schedule).
DMV candidates are highly preferred.
Must be comfortable working weekends as well (40 hours per week).

Overview

Work with a leading firm in the healthcare industry as a Medical Management Coordinator (MMC). In this vital remote role, you will support a dynamic non-clinical phone and fax team by ensuring patient data and authorization requests are managed with precision. This is an exceptional opportunity to utilize your prior authorization processing skills in a high-impact environment that directly influences patient care coordination and workflow efficiency.

Key Responsibilities

Execute the daily non-clinical entry and processing of prior authorization requests within internal management modules.
Access healthcare platforms to perform vital lookups, cross-referencing patient records to verify participant eligibility.
Manage a high volume of incoming non-clinical data streams via phone and fax channels.
Adhere to a structured, 40-hour weekly operational schedule, which includes mandatory partial coverage on both Saturdays and Sundays.
Track and key operational time accurately in accordance with team protocols and department guidelines.

Required Qualifications

Minimum of 1 year of direct experience in a Medical Management Coordinator (MMC) or Utilization Management Coordinator (UMC) capacity.
Proven, hands-on professional experience with prior authorization entry and processing.
Experience with CPT and ICD-10/diagnosis coding.
Prior Call center experience.
Candidates must possess and utilize their own fully functional computer equipment and home office setup (hardware is not provided by the client).
Total scheduling flexibility to work a 40-hour week distributed across 6 days, including 4 hours on Saturday and 4 hours on Sunday.
Strict capability to work and maintain regular business hours aligned with Eastern Standard Time (EST).

Preferred Qualifications

Prior operational knowledge or hands-on experience utilizing the Guiding Care system (highly preferred).
Prior operational knowledge or familiarity utilizing the Facets platform for eligibility verification (preferred).
Possession of a dual-monitor or multi-monitor home workstation to facilitate efficient multi-tasking across system platforms.