Kelly Services Utilization Management Representative in Albany, New York
Utilization Management Reps – Albany, NY
We are seeking Utilization Management Reps for a large healthcare insurance company located in Albany.
Title: Utilization Management Rep
Location: Albany (12211)
Pay: $17 hr.
Hours: M-F 8:30am-5pm
Type: Contract – possible temp to hire
Job Description: Responsible for coordinating cases for precertification and prior authorization review.
Managing incoming calls or incoming post services claims work.
Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
Refers cases requiring clinical review to a Nurse reviewer.
Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate.
Responds to telephone and written inquiries from clients, providers and in-house departments.
Conducts clinical screening process.
Authorizes initial set of sessions to provider.
Checks benefits for facility based treatment.
Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
High school diploma/GED
1 year of customer service or call-center experience
Proficient analytical, written and oral communication skills
Medical terminology training and experience in medical or insurance field preferred.
Call center experience is a plus
Apply now for immediate consideration!!
Please do not contact your local Kelly branch office as they are not filling this position.
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AboutKelly Services ®
As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people
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Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and is
committed to employing a diverse workforce. Equal Employment Opportunity
is The Law.