Intake Coordinator

This is a Fully Remote Job About Our Client:Guidehealth operates in the healthcare industry, focusing on improving healthcare affordability, patient health outcomes, and provider satisfaction. The organization uses data analytics, artificial intelligence, and a centralized managed service model to connect patients and providers effectively. It emphasizes value-based care and supports providers in delivering high-quality healthcare both within and beyond clinical settings. About the Opportunity:The INTAKE COORDINATOR is responsible for reviewing and approving routine referrals and pre-certifications for a Blue Cross HMO program. This role supports clinical services by managing referral screenings, ensuring compliance with protocols, and facilitating communication between providers, clinical staff, and claims personnel. The position contributes to the organization's operational efficiency and the smooth authorization of healthcare services. Responsibilities:Review and approve routine referrals and pre-certifications following established guidelinesConduct pre-review screenings on complex referrals and escalate as neededProvide clerical support including data entry and phone communicationEnter referral and pre-certification data accurately using ICD-10 and CPT codingMaintain confidentiality of healthcare informationAssist providers with referral and pre-certification inquiriesCollaborate with provider relations and claims staff to resolve discrepanciesSupport clinical services in maintaining internal referral manualsAdhere to audit proceduresPerform additional duties as assigned Requirements:Prior experience in a healthcare settingStrong knowledge of HMO structuresBasic proficiency with Excel and PDF or Adobe ProOrganizational and task-oriented skillsStrong time management abilitiesAbility to work independentlyPreferred: understanding of medical coding (CPT and ICD-9) and relevant advanced degrees or certifications Pay Range and Compensation Package:$20 - $21 per hour based on skills and experience Benefits & Perks:Remote work flexibilityComprehensive medical, dental, and vision insurance401(k) plan with 3% employer matchLife and disability insurance with voluntary life optionsEmployee Assistance ProgramPaid time offPaid parental leaveProfessional development resources 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.