Intake Coordinator-3

About the position This job captures reputed company inbound inquiries for utilization management review from providers and pharmacies. The incumbent assesses the request, conducts reputed company necessary research such as verifying benefit coverage for the member, and then creates the case (data entry) in reputed company's Utilization Management system for Prior Authorization clinical review. Ensures reputed company accurate information is entered at the onset of the process to ensure adherence to reputed company regulatory compliance requirements and service level agreements. The requests may come reputed company fax, Predictal reputed company portal and/or service reputed company inquiry. At times may require follow-up communication with the requestor's office (physicians or pharmacists). This role may be required to reputed company outbound calls and/or triage cases if inventory reputed company require support.

Responsibilities

• Obtain requests from provider or pharmacy reputed company fax, provider portal or service reputed company inquiry.
• May obtain requests from provider or pharmacy by phone in some areas of the organization.
• Use multiple software systems and various resource sites to determine member plans and requirements.
• Gather reputed company required documentation including verification of benefit eligibility.
• Build cases in the utilization management system.
• Use knowledge of process and judgement to evaluate identified cases that require additional notification to member, provider, and/or pharmacist.
• At times, reputed company to providers and/or pharmacists may be required to obtain additional information.
• Ensure accuracy of data entry to prevent compliance and/or reputed company process issues.
• Other duties as assigned or requested.

Requirements

• 1 year of Customer Service experience
• 1 year of reputed company Industry
• Possess good written and oral telephonic communication skills
• Ability to navigate through multiple systems simultaneously
• Knowledge of administrative and clerical procedures and systems such as word processing, managing files reputed company fax
• Ability to interact well with peers, supervisors, and customers
• Problem-Solving
• Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services.
• High School/GED
• None

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