Job Description:

The Intake Coordinator provides superior customer service to all inquiries and questions regarding preauthorization for members, providers, facilities, vendors, other departments and teams. Uses data and process to identify members in need of Care Management and takes the appropriate action to refer the member to our Care Management program.

Job Essentials

1. Participates in the identification, development, and implementation of new programs or process improvement initiatives by taking an active role or leading department project teams.
2. Receives incoming calls from members, providers, facilities, vendors, and other departments while providing professional solutions and information for situations and problems. Follows established guidelines to complete pre-authorizations for members and providers.
3. May supports the care management program over multiple disciplines by calling members and offering information/resources or engagement in Care Management, starting cases and tasking cases to the Care Manager.
4. Supports care management inbound referral process and starts readmission avoidance cases.  May make outbound calls to obtain or clarify clinical information needed to support the case.

5. Makes outbound calls as needed to obtain information for compliance with NCQA, CMS or other regulatory guidelines for completion of utilization review preauthorization service requests or concurrent reviews in a timely manner.

6. Notifies requesting providers of review outcome.

7. Indexes and distributes inbound requests from AWD and other documentation systems to appropriate team members in a timely fashion. Indexes and distributes cases to medical reviewers.

8. Completes report assignments in designated time frames. Reviews inpatient facility census and makes referrals to Care Manager as appropriate.

9. Complies with established auditing criteria for calls and pre-authorizations. Stays current and conversant on customer service call audit criteria as well as preauthorization and care management guidelines to provide accurate information, and follows all applicable regulatory guidelines (NCQA, CMS, State Medicaid)

10. Coordinates member needs with other SelectHealth departments.

Minimum Qualifications

Experience in medical office / insurance, or health related customer service.  Experience must include taking incoming or making outgoing telephone calls in a professional environment.Experience working successfully in a remote environmentDemonstrates proficiency using Microsoft Office Suite, including Teams (chat, whiteboard, task tracking) & Outlook; Capable of troubleshooting internet connection, basic computer hardware set-up, ability to customize computer settings and use multiple monitors.

Preferred Qualifications

Knowledge of medical terminology or medical background.Ability to work independently, demonstrates flexibility, and be self-motivated with a positive attitude.

Physical Requirements:

Interact with others requiring the employee to communicate information.
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Operate computers and other office equipment requiring the ability to move fingers and hands.
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See and read computer monitors and documents.
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Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.

Location:

SelectHealth - Murray

Work City:

Murray

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

$19.27 - $29.33

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado, Montana, and Kansas based caregivers; and our commitment to diversity, equity, and inclusion.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

All positions subject to close without notice.