Utilization Management Representative

Kelly 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