Utilization Management Coordinator

Pay Rate: $24/hr on W2Must-Have:Must have a Laptop/computer with internet to work from home.Comfortable providing a Photo ID CopyTerms of Employment: • Contract-to-Hire, Three Months • This position is 100% remote. Candidates must reside in MD, DC, or VA.• Hours: 8:30 AM – 5:00 PM EST.Overview:Join a leading healthcare organization as a Utilization Management Coordinator on the Commercial team. You will be the vital link between clinical teams and providers, ensuring that patient data is accurately captured so that claims can be processed efficiently. You will…• Manage high-volume inbound phone calls from provider offices and facilities.• Process incoming faxes and create medical authorizations.• Review patient cases for missing discharge dates and reach out to facilities to close information gaps.• Enter and update patient data within the GuidingCare and Facets platforms.Required Qualifications:• High School Diploma and 3+ years of administrative experience in healthcare or health insurance.• Mandatory previous Call Center experience.• 2+ years of experience with CPT and ICD-10/diagnosis coding.• Strong proficiency in Microsoft Office (Excel, Outlook, Teams).Preferred Qualifications:• Experience using GuidingCare (Strongly Preferred).• Familiarity with Facets or Nice CXone (online phone system).