Full-Time Health Services Intake Specialist

About the Role: We are seeking a Health Services Intake Specialist to work in a call center, handling care management tasks. Responsibilities include eligibility and benefit verification, authorization status inquiries, data collection/documentation, precertification and notification requests, and providing administrative support to care management teams.

About You: We seek a dedicated, customer-focused healthcare professional. You should enjoy collaborating with multi-disciplinary teams, managing diverse responsibilities, and researching guidelines. Strong communication and organizational skills are essential.

Training: Initial six-week training at our Des Moines, IA office, followed by remote work or a hybrid schedule.

Required Qualifications:

• High School Diploma or GED
• 1+ years related experience (customer service, provider service, developing customer relationships, obtaining information, documenting conversations, health insurance/healthcare industry)
• Experience in a production environment with metrics
• Strong critical thinking skills to resolve issues and maintain composure
• Ability to prioritize and meet deadlines
• Strong written and verbal communication skills
• Proficiency with Microsoft Office
• Excellent attendance and punctuality
• Comfort in a high-volume, fast-paced call center environment

Responsibilities:

1. Verify member eligibility and benefits, provider participation, and network status
2. Accurately document information received (phone, fax, provider portal) in JIVA
3. Support Nurse Care Managers by creating episodes for services and admissions
4. Create and send letters to providers/members regarding authorization outcomes
5. Manage workload within regulatory deadlines
6. Provide accurate information to members and providers using current guidelines
7. Meet quality assurance and production metrics
8. Understand and interpret regulatory/accreditation standards, Health Services guidelines, and HIPAA requirements
9. Comply with regulations and internal guidelines

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