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Intake Coordinator Jobs
Company | Brighton Health Plan Solutions |
Address | New York, United States |
Employment type | FULL_TIME |
Salary | |
Category | Internet Publishing |
Expires | 2023-06-03 |
Posted at | 1 year ago |
About The Role
- Interact telephonically with employers, employees, physicians and insurance adjusters to determine medical status, type of care needed (surgery, hospitalization and/or physical therapy) and future needs of care as needed.
- Mail correspondence to member/provider/facility.
- Answer and handle call center calls within required time frames.
- Inform callers that the Nurse Case Reviewer may obtain additional medical information for review and certification.
- Create cases within Medical Management system in accordance with departmental workflows, policies and procedures.
- Adhere to established quality assurance standards and all MagnaCare policies and procedures.
- Discuss and document any concerns, complaints and/or issues with direct supervisor.
- Is kind, caring, sympathetic and positive with all customers and fellow employees.
- Data entry of required case information including transcription of clinical information.
- Collect data upon notification from patient/patient representative, physician, or hospital; verify member eligibility, plan participation and provider participation status.
- Maintain accurate records of individual cases; create, scan, fax and upload correspondence and documentation as required.
- (In regard to discharge planning for workers’ compensation patients) direct participants to facilities and providers as close to their desired location as possible. Reductions, restrictions and coordination of special situations are also communicated.
- Ability to work in a database environment a plus.
- Strong skills in medical record review.
- HS diploma or GED is required.
- Current knowledge of workers compensation and legislative issues a plus.
- Ability to define problems, obtain data, and establish facts.
- Bachelor’s degree preferred, but not required.
- Excellent customer service and communication skills.
- Familiarity with medical terminology a plus.
- Previous experience in case management handling insurance claims a plus.
- Ability to work proficiently on a computer (PC) with working knowledge of Microsoft Word and Excel.
- Excellent data entry skills.
- We are an Equal Opportunity Employer
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