Utilization coordinator vs case management coordinator

Differences between utilization coordinator and case management coordinator duties and responsibilities

Utilization coordinator example responsibilities.

• Manage and coordinate authorization of denial letters and request for appeals with all levels of services.
• Manage and coordinate the workload of the release team members and are responsible for organizing and hosting all production release windows.
• Perform accurate verification of eligibility and benefits as well as advanced application of CPT, ICD-9 and ICD-10 codes.
• Assign accurate ICD-9 and CPT codes to request services for referral and authorization processing.
• Claim adjudication for assign HMO members.
• Provide orientation to pre-certification process for HMO, PPO, and POS members.
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Case management coordinator example responsibilities.

• Manage caseload by providing care coordination to individuals with a primary intellectual/developmental disability diagnosis all of whom receive community-base waiver services.
• Discharge planning including but not limit to rehabilitation, durable medical equipment and home healthcare.
• Provide counseling support to clients with mental illness, HIV/AIDS, autism, and handicaps.
• Act as medical resource for appeals function.
• Input client's information into HMIS portal database.
• Design custom reports within AVAYA CMS used to assist with forecast and staff implementation.
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