Kelly Services is seeking an Customer Service/ Utilization Management Rep for a healthcare company in Albany, NY!
Job Title: Customer Service/ Utilization Management Rep
Location: Albany NY
Type: Contract (W2)
Length: 3+ months
Pay Rate - $17.25/hour
Shift: (*) Must be flexible to work between the hours of 8:00am- 8:00pm (training 4 weeks from 8:30am-5:00pm)
This is 100% in-bound call center. It is a fast-paced environment. Your day is primarily spent answering calls from providers who are inquiring as to whether or not a certain procedure requires prior authorization for one of our members who has group health insurance through their employer. We use our tools to determine if the authorization is required. If it is required we build cases and send them to our clinical team. We are the front line to our clinical staff.
Responsible for coordinating cases for precertification and prior authorization review. Primary duties may include, but are not limited: 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.
Requires High school diploma/GED; 1 year of customer service or call-center experience; proficient analytical, written and oral communication skills; or any combination of education and experience, which would provide an equivalent background. Medical terminology training and experience
- As a Kelly Services employee, you will have access to numerous perks, including:
- Exposure to a variety of career opportunities as a result of our expansive network of client companies
- A competitive hourly pay rate with weekly checks
- Access to newly expanded Medical Plan options
- Online continuing education via the Kelly Learning Center
- Several employee discounts
- And more!
As a worker today, it's up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find what's next is what we're all about. We know what's going on in the evolving world of work—just ask the nearly 500,000 people we employ each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.About Kelly®
At Kelly, we're always thinking about what's next and advising job seekers on new ways of working to reach their full potential. In fact, we're a leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.
Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females, individuals with disabilities, protected veterans, sexual orientation, gender identity. Equal Employment Opportunity is The Law.]] About Kelly Services
Kelly Services, Inc. (NASDAQ: KELYA, KELYB) is a leader in providing workforce solutions.
Kelly offers a comprehensive array of outsourcing and consulting services as well as world-class staffing on a temporary, temporary-to-hire, and direct-hire basis.
Serving clients around the globe, Kelly provided employment to more than 540,000 employees in 2013. Revenue in 2013 was $5.4 billion.
Apply on company website