Patient Intake Coordinator

2 weeks ago

Greensboro, North Carolina, United States Care N Care Insurance Company of North Carolina Full time
Job Overview

POSITION SUMMARY

KEY RESPONSIBILITIES

The individual in this role will be responsible for:

Authorization Request Management:

  • Execute precise data entry with a focus on minimizing errors. Ensure that all received documents are accurately recorded in the system.
  • Provide prompt verbal and/or written notifications regarding determinations to both providers and members.
  • Exhibit the ability to manage multiple tasks while maintaining attention to detail in a dynamic environment.
  • Meet and uphold productivity standards consistently.
  • Handle the routing and processing of all Out of Preferred Network and Out of Network requests, ensuring adherence to the appropriate clinical team protocols for denial preparations.
  • Assist Utilization Management (UM) Clinical staff in acquiring clinical data, tracking request statuses, and monitoring admission and discharge processes.

Compliance with Regulations:

  • Utilize the company's prior authorization list and non-clinical algorithms effectively, adhering to network tier structures and preauthorization requirements set by health plans.
  • Ensure compliance with all regulatory mandates regarding turnaround times, notifications to providers/members, and maintaining HIPAA standards.

Customer Engagement:

  • Demonstrate strong critical thinking skills and meticulous attention to detail.
  • Manage a high volume of inbound and outbound calls, delivering exceptional customer service while meeting established call metrics.
  • Support various special projects related to UM functions and customer service initiatives.
  • Perform additional duties as assigned.

EDUCATIONAL BACKGROUND AND EXPERIENCE

Education:

  • Associate degree or equivalent combination of education and experience.

Required Experience:

  • Minimum of one year of full-time experience in a healthcare office environment.

Preferred Experience:

  • Familiarity with professional standards of practice in a healthcare setting.
  • Understanding of regulatory and managed care requirements.
  • Proven accuracy in data entry.
  • Strong typing skills and effective phone communication.

ADDITIONAL REQUIREMENTS:

  • Successful completion of required assessments.
  • Annual influenza vaccination.

SKILLS AND COMPETENCIES

Essential Skills:

  • Proficient in typing and using various software applications, including Microsoft Office Suite.
  • Ability to utilize spreadsheet and database programs effectively.

PHYSICAL DEMANDS

  • Occasional exertion of up to 10 pounds of force and frequent negligible force to move objects.
  • Primarily sedentary work, with occasional walking or standing required.

ABOUT CARE N CARE INSURANCE COMPANY OF NORTH CAROLINA

Care N Care Insurance Company is committed to providing equal employment opportunities. All applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Care N Care offers a range of Medicare Advantage plans to eligible beneficiaries across North Carolina. We are dedicated to creating a supportive work environment and are proud to be recognized as a leading employer in the region.

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