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Medical Claims / PreService Assistant

Kelly Services


Location:
Chattanooga, TN
Date:
04/19/2018
2018-04-192018-05-19
Job Code:
US5611LG_24746497
Categories:
  • Healthcare
  • Coordinators
Kelly Services
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Job Details

Job Title Medical Claims / PreService Assistant

Jobid US5611LG_24746497

Location: Chattanooga, TN, 37404, USA

Description **Job Description**

Kelly Services has an immediate need for a Claims / Utilization Coordinator with a well-known company in the Chattanooga downtown area. Please apply online or call us at 423 892-8964 for more details. This is a great temporary opportunity to get visibility with an outstanding company!

Responsibilities:

- Answer Care Management telephone inquiries from Providers and members regarding Case Management and Disease Management.

- Answer inquiries from providers regarding the Utilization Management program.

- Reviews and communicates the physician reviewers medical decisions for prior authorization requests to the provider and/or facilities via telephone, fax, letter and/or e-mail to all providers involved in each case.

- Interact daily with members, facilities and providers advising them of decisions to approve, extend, or deny services.

- Review and handle Customer Service and Claims issues

- Research and resolve problems with physicians, providers, and practitioners or forward to appropriate personnel for handling.

- Load complete authorizations/Notifications for services designated by internal policy.

- Enter appropriate diagnosis and/or procedure code as part of the notification/prior authorization process.

- Handle benefit exclusion request and generate manual letters to members

- Refer cases appropriately to Care Management and/or Transition of Care.

**Requirements**

Education

- High School Diploma or Equivalent work experience with a minimum of 2 years medical or business experience.

- Minimum 2 year Customer Service or Claims experience required.

- Minimum of 1 year experience in Health Care Services.

Skills/Certifications

- Extensive knowledge of UM program including claims, correspondence, and denial/appeals process.

- Exceptional telephone and written communication skills.

- Ability to dialogue with providers and members effectively.

- Ability to make sound independent decisions.

- Ability to read and understand medical terminology.

- Experience with personal computers, FACETS, and related reporting systems, Word/Excel helpful but not required.

- Handle interruptions, set priorities, adapt to change.

- Type 45 wpm

Please apply online or call us at 423 892-8964 for more details.

**Why Kelly** **®** **?**

At KellyServices ® , we work with the best. Our clients include 95 of the Fortune100 ™ companies, and more than 70,000 hiring managers rely on Kelly annually to accessthe best talent to drive their business forward. If you only make one career connection today, connectwith Kelly.

**AboutKelly Services** **®**


As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 peoplearound the world and have a role in connecting thousands more with work through our global network oftalent suppliers and partners. Revenue in 2017 was $5.4 billion. Visit kellyservices.com and connect with us on Facebook, LinkedIn and Twitter .

Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females,Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and iscommitted to employing a diverse workforce. Equal Employment Opportunityis The Law.



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