7 days old

Utilization Management Representative

Kelly Services
Newbury Park, CA 91320
**Utilization Management Reps - Newbury Park, CA**

**We are seeking Utilization Management Reps for a large healthcare insurance company located in Newbury, Park.**

**Title:** Utilization Management Rep

**Location:** Newbury Park

**Pay:** $18 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.

**Job Responsibilities:**

+ 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.

**Job Requirements:**

+ 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._**

**Why Kelly** **** **?**

At Kelly
Services , we work with the best. Our clients include 95 of the Fortune
100 companies, and more than 70,000 hiring managers rely on Kelly annually to access
the best talent to drive their business forward. If you only make one career connection today, connect
with Kelly.

**AboutKelly Services** ****

As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people
around the world and have a role in connecting thousands more with work through our global network of
talent suppliers and partners. Revenue in 2017 was $5.4 billion. Visit 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 is
committed to employing a diverse workforce. Equal Employment Opportunity
is The Law.
Posted: 2019-06-10 Expires: 2019-07-11

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Utilization Management Representative

Kelly Services
Newbury Park, CA 91320

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