Intake Coordinator

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health .
Job Summary
Respond to provider queries, enter administrative authorization data into the computer system, and maintain proper documentation and files to support care of members, customer service, and other departmental functions. Enters all referral/data information into the computer system, maintains proper documentation and facilitates coordination of services. The position will be directly associated with incoming referrals and authorizations for the utilization component of medical management. Job Description

Key Responsibilities/Duties – what you will be doing:

- Receives incoming authorization requests from providers, via fax, portal & telephone to create an event or transaction by lines of business for the UM teams to review and decision requests

- Contacts provider offices for further details on clinical information.

- Research member eligibility and primary care selection to complete entry of the event.

- Documents and maintains all telephone calls and enters a note on each call/inquiry made. Documents all admissions, and referrals. Maintains flow and storage of information such as messages, forms, and logs.

- Works with providers and other members to solve complex and urgent issues. Ensures that appropriate person/department from across the organization is appropriately involved with applicable issues.

- Data entry of Authorization Requests for all Inpatient stays – Outpatient requests as needed, into information system.

- Represents Medical Management at applicable activities including system user groups and other health data system organizations.

- Attends organization-wide meetings and department staff meetings.

- Maintains professional growth and development through self-directed learning activities and involvement in professional, civic and community organizations.

- Other duties as assigned by the Intake and Outreach Coordination leadership.

Qualifications – what you need to perform the job
Certification and Licensure
Education

- Required (minimum): Associates’ degree or equivalent relevant work experience.

- Preferred:

Experience

- Required (minimum): Two plus years of experience in a business environment

- Preferred: Managed care/health industry environment experience.

Skill Requirements

- Exhibits exceptional internal and external customer service skills.

- Ability to work in clinical and company databases

- Excellent verbal and written communication skills generally acquired through college or other advanced education are required.

- Must be able to demonstrate proficiency and accuracy in performing data entry tasks in multiple applications

- Individuals must be able to appropriately identify urgent situations and follow the appropriate protocol.

- Position also requires the ability to manage multiple priorities as well as having the initiative, judgment, and perception to operate independently and in a partnership with other departments.

- Individuals must possess strong organizational a