Cynet Systems ยท 4 days ago
Utilization Management Coordinator - Remote / Telecommute
United States
Full-time
Remote
Mid Level
3+ years expCynet Systems is seeking a Utilization Management Coordinator to provide administrative and coordination support related to member and provider services. This role focuses on authorization processing, claims-related support, departmental coordination, reporting, and data tracking while ensuring accuracy and compliance across teams.
EmploymentRecruitingStaffing Agency
Responsibilities
Perform member and provider administrative support including benefit verification, authorization creation and management, claims inquiries, and case documentation
Review authorization requests for initial determination and triage cases for clinical review and resolution
Provide general departmental support including answering calls, responding to inquiries, taking messages, preparing correspondence, researching information, and assisting with problem resolution
Assist with reporting, data tracking, data gathering, organization, and dissemination of information including Continuity of Care processes and Peer-to-Peer review tracking
Qualification
Required
Three years of experience in healthcare claims, healthcare service areas, or office support
Strong communication, organizational, and customer service skills
Ability to work effectively within a multidisciplinary team including internal and external participants
Knowledge of basic medical terminology and managed care concepts
Ability to apply standardized processes and procedures for evaluating medical support operations
Strong independent judgment and decision-making skills with tact and diplomacy
High attention to detail
Proficiency in web-based technology and Microsoft Office applications including Word, Excel, and PowerPoint
High school diploma or equivalent
Preferred
Experience in a healthcare or managed care setting
Knowledge of CPT and ICD-10 coding
Company
Cynet Systems
Headquartered in Washington DC Metro Area, Cynet Systems is a top talent supplier for companies across North America.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Ashwani (Ash) M.
Partner and Co-CEO
Nikhil "Nick" Budhiraja
Founder / Co-CEO
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