Utilization coordinator vs medication coordinator

Differences between utilization coordinator and medication 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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Medication coordinator example responsibilities.

• Manage patient's accounts collecting and billing financial statements, budgets and expertise with CPT and ICD-9 coding.
• Manage inpatient transfers to rehabilitation and medical facilities, along with preparing and monitoring outpatient billings insurance verification and referrals.
• Complete records after patients complete all medical appointments, typing intake forms and additional entries/forms, and obtain physician signatures.
• Navigate effectively through an electronic medical records (EMR) system.
• Develop plan for confidentiality of client and agency information through HIPAA guidelines.
• Perform Medicare and Medicaid audits on members using company medical policy and establish criteria for H.C.F.A.
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