Kelly Services Pre-Service Claims Assistant in Chattanooga, Tennessee

Job Description

Kelly Services has an immediate need for multiple Pre-service Claims Assistants with a well-known insurance company in the Chattanooga downtown area. Please apply online or call us at 423 892-8964 for more details or send your resume to 5611@kellyservices.com. 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

  • 2 years Claims and Customer Service experience

  • Knowledge of Medical terminology

  • Proficient computer skills in MS Office

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 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.