Medical Management Intake Specialist

1 week ago


Reston, Virginia, United States W3R Consulting Full time

Job Summary:

We are seeking a highly motivated Medical Management Intake Specialist to join our Commercial Inpatient team at W3R Consulting. This role is 100% remote, and we are looking for candidates with strong healthcare management skills.

Key Responsibilities:

  • Handle inbound and outbound calls with excellent phone skills and provide customer service as the first trusted source for Utilization Management (UM) Prior Authorization programs.
  • Process provider requests and assign faxes to designated staff, ensuring accurate and timely documentation.
  • Access and manage various UM department mailboxes and voicemails, maintaining a high level of organization and attention to detail.
  • Enter documentation accurately into Care Advance, utilizing strong analytical skills to identify trends and areas for improvement.
  • Build and maintain positive relationships with colleagues, clients, and stakeholders, fostering a collaborative and supportive work environment.

Requirements:

  • Minimum of 2 years of experience in healthcare, insurance, or a related field, with a strong understanding of health insurance processes, including claims management, benefits coordination, and prior authorization.
  • High school graduate with college or university experience, and medical terminology knowledge or a medical background is required.
  • Excellent verbal and written communication skills, with the ability to work collaboratively with cross-functional teams and adapt to changing priorities.
  • Experience with healthcare management software and databases, with a strong attention to detail and ability to work independently.

Work Environment:

  • Monday through Friday, 8:00 AM to 5:00 PM, with flexibility for some Saturdays, Sundays, and Holidays; overtime may be required.


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