Associate Intake Coordinator

Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for completing all Prior Authorization outbound call tasks and/or inbound triage case creations. In compliance with regulatory guidelines (e.g., NCQA, CMS), the incumbent informs the member and/or provider of the approval and/or denial of the requested authorization. ESSENTIAL RESPONSIBILITIES Obtain call task from Utilization Management platform, perform verbal outbound call task requirement following a detailed script and desk level procedure, and appropriately log result within the platform. Obtain triage task from Utilization Management platform and follow a detailed desk level procedure to enter the required fields to set up the case build (data entry) and set the urgency of the case creation for the Intake Coordinator. Other duties as assigned or requested. EXPERIENCE Required None Preferred 1 year of Customer Service experience 1 year of Call Center experience 1 year of Healthcare experience SKILLS 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 and digital fax Ability to interact well with peers, supervisors, and customers EDUCATION Required High School Diploma Preferred None LICENSES or CERTIFICATIONS Required None Preferred None Language (Other than English): None Travel Requirement: 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office- or Remote-based Physical work site required Constantly Travel Required 0% - 25% Audible Speech Frequently Hear Frequently Position self or move lower on ground, under tables/desk, etc. Occasionally Climb Occasionally Drive Never Reach Occasionally Sedentary Position Constantly Move Occasionally Repetitive Motion Constantly Use Hands/Fingers to Handle or Feel (beyond data entry) Occasionally Vision - Distinguish Color Occasionally Vision - Far, near, Depth Perception Occasionally Lifting: up to 10 pounds Constantly Lifting: up to 20 pounds Occasionally Lifting: up to 50 pounds Never Lifting in excess of 50 pounds Never Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $19.39 Pay Range Maximum: $24.19 Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at [email protected] California Consumer Privacy Act Employees, Contractors, and Applicants Notice