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Job Requirements of Intake Agent:
-
Employment Type:
Contractor
-
Location:
Rhode Island, US (Onsite)
Do you meet the requirements for this job?
Intake Agent
Careers Integrated Resources Inc
Rhode Island, US (Onsite)
Contractor
Job Title: Intake Agent
Location: Remote
Duration: 6 Months
Shift: M-F 8-5
Job Description:
Experience:
Required Education:
Location: Remote
Duration: 6 Months
Shift: M-F 8-5
Job Description:
- Performs intake of calls from members or providers regarding services via telephone, fax, EDI.
- Utilize Profax, Dynamo and QNXT and other Healthcare systems to build LTSS cases, research and enter member information.
- Screens requests for appropriate referral to medical services staff.
- Coordination of Medical, LTSS including Care Team intake and outreach, screening and supporting care plans.
- Approve services that do not require a medical review in accordance with the benefit plan.
- Performs non-medical research including eligibility verification, COB, and benefits verification.
- Assists Case Managers with coordination of benefits and services.
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
- Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., claim administrators, Plan Sponsors, and third party payers as well as member, family, and health care team members respectively)
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality Communicate with Healthcare Case Managers, when processing transactions for members active in this Program Supports the administration of the precertification process in compliance with various laws and regulations, URAQ and/or NCQA standards, where applicable, while adhering to company policy and procedures.
- Places outbound calls to providers to gather additional information for authorizations.
- Sedentary work involving significant periods of sitting, talking, hearing and keying.
- Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor.
- Working environment includes typical office/ work from home conditions.
Experience:
- High School Diploma or G.E.D.
- 1-3 years Call Center Experience (preferred, but not required)
Required Education:
- High School diploma, G.E.D. or equivalent experience
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