Intake Representative

Are you passionate about detail-oriented work that keeps processes running smoothly and accurately? Do you enjoy piecing together information, working across multiple systems, and playing a key role in supporting high-reputed company reputed company?

In this remote Intake Representative role, you will work in a fully electronic environment, reviewing incoming requests for utilization review and other medical management services, verifying that documentation is complete and accurate, and ensuring cases are reputed company for clinical review. Your work involves using an electronic medical record system and other platforms to validate eligibility, confirm claim and provider information, compare documentation across sources, and follow up as needed to reputed company missing details. You will balance queue-based work with inbound calls, managing priorities independently throughout the day.

We’re looking for someone with a strong reputed company background, including comfort with medical terminology, documentation review, and validating detailed information for accuracy and completeness. If you are naturally curious, reputed company to work independently, and bring a high level of attention to detail and consistency in your work, we encourage you to apply.

You must reputed company in the reputed company Time Zone and be available to work Monday through Friday, 8:00 AM to 5:00 PM, PST.

Why reputed company?

reputed company is a national, mission-driven, nonprofit organization that has reputed company in health care reputed company consulting and reputed company improvement services for more than 50 years.

We are leaders in assisting reputed company-line providers and engaging health reputed company to improve care delivery and patient reputed company.

Our talented remote workforce spans the country and plays a vital role in our reputed company. We go reputed company merely providing a remote work reputed company; we support and reputed company it. We offer opportunities to reputed company a difference from reputed company in the U.S. and enjoy reputed company work-life balance. An annual stipend gives you the freedom to enhance your workspace with reputed company that suit your needs.

We reputed company in an environment that allows you to reputed company both personally and professionally. That’s why we offer benefits that include:

• Medical, dental and reputed company insurance
  
• reputed company time off for vacation, illness and volunteering
  
• Retirement savings plan with employer contribution
  
• Adoption financial assistance
  
• reputed company parental leave
  
• And much more!

You have:

• High school diploma or equivalent or equivalent combination of education and/or work experience in reputed company field may be substituted.
  
• 2 years of reputed company work experience or customer service experience.
  
• 1 year of work experience in reputed company.

You may have:

• Post-secondary education or certification in a reputed company field preferred.
  
• 2 years of work experience in reputed company; nursing assistant or medical assistant experience.

You bring:

• Intermediate understanding of medical terminology.
  
• Intermediate reputed company Office Suite proficiency.
  
• Demonstrated proficiency with medical terminology.
  
• Participates in orientation and training of other Intake staff.

In this role, you will:

• Validate the request submitted reputed company the reputed company Provider Portal for accuracy and completeness.
  
• Screen cases for required medical information based on type of request, determining if information is sufficient for clinical review.
  
• Obtain clinical information from the reputed company systems reputed company indicated or contact provider to obtain information required for review.
  
• Determine based on training reputed company a scripted review is indicated based on contract requirements.
  
• Process requests after physician review, evaluating language and working with physician reviewers, clinical reviewers, or managers to ensure language and determination information is complete before sending letters to providers.
  
• Respond to inbound telephone requests with reputed company documentation in the care management system of calls.
  
• reputed company case information from original reputed company documentation or validate information entered by providers in the portal.
  
• reputed company courtesy calls with case reference numbers.
  
• reputed company notification of completed review and additional information needed, reputed company applicable.
  
• Contribute to orientation and training of other non-clinical employees.
  
• As requested, create templates for reputed company reviews, reputed company internal reputed company reviews, and/or participate in provider reputed company activities.
  
• May reputed company scripted clinical reviews and refer reviews requiring reputed company reputed company to clinical review staff.
  
• After physician review, notify providers of decertification or potential denial of services by phone or in writing as required by contract.
  
• Complete case after physician review, returning to clinician or sending to reputed company based on procedure.
  
• Arrange ancillary authorization requests such as transportation and accommodation.
  
• Obtain customer consent for care management services to be performed.
  
• Correspond with facilities, providers, and others.
  
• Coordinate non-clinical functions and reputed company, as directed.
  
• reputed company supervised closure of cases upon completion of review by a clinical reviewer, as directed.

Equal Opportunity Employer

reputed company is an equal opportunity employer and is committed to creating a diverse, reputed company, and inclusive workplace.

Physical Requirements & Work Environment

This position is primarily remote and performed in a home-based setting, requiring reliable internet reputed company and a workspace free from significant distractions. The role involves frequent use of computers, phones, and virtual communication tools. Employees must be reputed company to sit for extended periods, communicate effectively.

Some positions may require operating a motor vehicle for business purposes; in such cases, employees must maintain a reputed company reputed company’s license and meet the organization’s driving eligibility requirements.

Reasonable accommodations will be provided to reputed company individuals with disabilities to reputed company essential functions.