JobWatch

10 days old

Utilization Management Representatives (After Hours - St Louis, MO

Kelly Services
St Louis, MO 63103
Kelly is currently looking for an **Utilization Management Representative (** After Hours) for one of our top clients in **St Louis, MO.** (~Work from home to start!)


**Pay Rate: $18.50/hour**

**Schedule: After Hours--12-hour shifts between the times of 5pm-8am ET Mon-Fri, 8am-8pm ET or 8pm-8am ET on weekends and all major holidays.**

**Typically 36 hours per week.**

**Duration: 6 Months (Possible ~Work from home to start!)**

**Anticipated start date: March 2021**


**DUTIES**

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.

Obtains intake (demographic) information from caller.

Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given.

Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care.

Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.

Verifies benefits and/or eligibility information.

May act as liaison between Medical Management and internal departments.

Responds to telephone and written inquiries from clients, providers and in-house departments.

Conducts clinical screening process.


**EDUCATION/ EXPERIENCE**

High School/ GED diploma

2 years customer service experience in healthcare related setting

Medical terminology training;

MS Office Proficiency

Great communication skills, able to work independently


**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.


**About Kelly 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 2016 was $5.3 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 is committed to employing a diverse workforce. Equal Employment Opportunity is The Law.


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


As a worker today, its up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find whats next is what were all about. We know whats going on in the evolving world of workjust ask the 440,000 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, were always thinking about whats next and advising job seekers on new ways of working to reach their full potential. In fact, were a leading advocate for temporary/non-traditional 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 and providing accommodations for people with disabilities in all parts of the hiring process as required under its Employment Accommodation Policy. Kelly will work with applicants to meet accommodation needs that are made known to Kelly in advance.
Posted: 2021-02-15 Expires: 2021-03-18

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

Utilization Management Representatives (After Hours - St Louis, MO

Kelly Services
St Louis, MO 63103

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast