Utilization Review Coordinator

Utilization Review Coordinator PRIMARY PURPOSE OF

THE ROLE:

To provide excellent customer service and internal support to an assigned team.

Ideal candidates will thrive in a collaborative team environment, show motivation and drive in their work ethic, are customer‑oriented, naturally empathetic and solution‑focused.

• Accesses, triages, and assigns cases for utilization review (UR).
• Responds to telephone inquiries providing accurate information and triage as necessary.
• Enters demographics and UR information into claims or clinical management system; maintains data integrity.
• Obtains all necessary information required for UR processing from internal and external sources per policies and procedures.
• Distributes incoming and outgoing correspondence, faxes and mail; uploads review documents into paperless system as necessary.
• Supports other units as needed.

• Education & Licensing:
  High school diploma or GED required.
• Skills:
  
  Strong oral and written communication, computer literate – including Microsoft Office, organizational skills required.
• Experience:
  
  Clerical or customer service experience or equivalent combination of education and experience preferred.

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment. [IF APPLICABLE]
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one.

Physical:
Computer keyboarding

Auditory/visual:
Hearing, vision and talking

Mental:
Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $18.00 – $20.00/hr a comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace.