Utilization Management Rep I
- Location
- Albany, NY
- Listed
- Today
Primary duties may includes, but are not limited
- 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.
Qualifications & Requirements
Education/experience
Requires High school diploma; 1 year of customer service or call-center experience; proficient analytical, written and oral communication skills; or any combination of education and experience, which would provide an equivalent background. Medical terminology training and experience in medical or insurance field preferred.
Additional Information
Must be independent worker - not dependent on using their cell phones all day. Hard workers and dedicated to the work they are doing.
About the Company
Mindlance is a national recruiting company which partners with many of the leading employers across the country.
From Mindlance's careers page, first listed on Rolev.ai on November 14, 2026. Rolev.ai is not the employer.
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More at Mindlance
All Mindlance jobsCommon questions
Where is the Utilization Management Rep I job at Mindlance located?
This Utilization Management Rep I position at Mindlance is located in Albany, NY. Always check Mindlance's application page for specific state eligibility or relocation policies.
How do I apply for the Utilization Management Rep I position at Mindlance?
This listing links directly to Mindlance's SmartRecruiters application page. You can apply directly on Mindlance's site, or use Rolev.ai to check your resume fit, generate a zero-hallucination tailored resume and cover letter for this posting, and autofill the SmartRecruiters application form in 1 click with the Rolev.ai Chrome extension. You always review the form and press Submit yourself.