Utilization Management Representative
Partnered Staffing - Kelly Services
Apply to this jobKelly Services
MAJOR DUTIES AND RESPONSIBILITIES
• Responsible for coordinating cases for precertification and prior authorization review.
• Manages incoming calls, including triage, opening of cases and authorizing sessions.
• 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.
EDUCATION/EXPERIENCE
• High school diploma or equivalent.
• Minimum of 2 years of customer service call-center experience is required.
• Experience in medical or insurance field strongly preferred.
• PC proficiency.
Pay Rate 16.75 per Hour
Summary
Coordinate case reviews, manage calls, conduct clinical screening, and handle customer inquiries in healthcare.
Job title
Utilization Management Representative
Experience level
2+ years
Industry
healthcare
Location requirements
Albany, NY, US; on-site role
Salary
16.75 per Hour
Visa sponsorship
H-1B sponsor history
Management role
No
Required skills
Preferred skills
Specializations
Structured locations inferred from the posting.
Albany, NY, USA