Clinical Intake Specialist

This is a Fully Remote Job 1. About Our Client:This organization operates in the health plan solutions industry, addressing the challenges of one-size-fits-none PPO insurance models. It leverages decades of expertise in self-funded healthcare to provide customized, member-focused plans aimed at helping employers reduce healthcare costs. 2. About the Opportunity:The Clinical Intake Specialist is responsible for initiating the medical management notification process using electronic systems and providing non-clinical support within the Medical Management department. This role ensures accurate and compliant data handling, prioritizes intake calls, and facilitates communication between providers and the organization to support effective medical management. 3. Responsibilities:Perform tasks following Department of Labor, HIPAA, ERISA, and Medical Management policies and proceduresUse software and office equipment to accurately complete notification processesPrioritize calls in the telephonic intake queue appropriatelyRefer clinical matters to licensed staff when neededProvide HIPAA-compliant information regarding medical service notificationsEnter notification data and obtain clinical information as requiredConfirm dates of service with providers/facilities and document in case tracking softwareMaintain accurate documentation in designated software systemsEngage professionally in all internal and external communicationsAttend required meetings, trainings, and job-specific eventsParticipate in Quality Management programs according to policyPrepare reports as assignedUse scripted communication consistently 4. Requirements:High School Diploma or equivalentExperience working remotelyExperience in a high-volume work environmentKnowledge of medical terminology 5. Pay Range and Compensation Package:The pay range and compensation package for this role will be determined based on the candidate’s experience, skills, and other relevant factors. 6. Benefits & Perks:Multiple health plan optionsCompany-paid premiums for disability and life insuranceParental leave policy20 days PTO to start and 10 paid holidaysTuition reimbursement401(k) company contributionCompany-paid short and long term disability plus life insuranceProfessional development and continuous learning opportunitiesOpportunities to engage in diversity and inclusion initiatives Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.