Intake Specialist

We’re hiring an Intake Specialist to join the Commercial UM Operations Team! Based on established guidelines, the Intake Specialist processes a variety of internal and external member/provider requests and transactions, receives, screens, and enters data in preparation for review. Complies with timeliness standards and reduces unpaid claims and rework by accurately processing requests. May also assist on special projects as needed.

Responsibilities

• Process a variety of requests, inquiries and transactions via phone, email, fax, and mail
• Review requests to ensure accuracy
• Support internal & external customers via phone or email
• Document all pertinent information related to the call/inquiry, attach supporting information as applicable and if unable to resolve route to appropriate area for follow up as applicable
• Gather and analyze data to provide feedback to Team Leads on employee development needs and/or specific providers requiring education on prior approval or pre-certification process
• Screen inquiries to determine if authorization is required
• Verify member benefits and eligibility and/or provider setup
• Maintain and update Service Requests and research incorrect or missing information
• Triage and assign all incoming inquiries in a timely, efficient manner throughout the day to appropriate staff
• Perform Peer Audits monthly as required
• Provide clinical review outcome notification to members and providers (verbal and written)

Requirements

• High school diploma or GED
• 3+ years of experience in related field

Qualifications

• Prior telephone-based customer service experience strongly preferred
• Familiarity with and understanding of medical terminology is a plus

Benefits

• Medical, dental, and vision coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education
• 401k match including an annual company contribution
• Paid Time Off (PTO)

Pay

$41,600.00 - $66,561.00 annual base salary. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications, and other business and organizational needs. Base salary is part of a robust Total Rewards package that includes an annual incentive bonus, 401(k) with employer match, and competitive health benefits and wellness programs.

Schedule

Our Hybrid Flex approach requires working in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments. Onsite expectations will be discussed during the interview process.