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Intake Coordinator - Peak Health

Remote: 
Full Remote
Contract: 
Full time
Experience: 
Mid-level (2-5 years)
Work from: 
United States

Offer summary

Qualifications:

High School diploma or GED, 1 year in healthcare and customer service.

Key responsabilities:

  • Manages inbound requests for utilization review
  • Enters and verifies data accuracy in systems
WVU Medicine logo
WVU Medicine XLarge https://www.wvumedicine.org/
10001 Employees
About WVU Medicine
The WVU Health System, which operates under the brand name WVU Medicine, is comprised of 22 member, managed, and affiliated hospitals in West Virginia, Maryland, Ohio, and Pennsylvania. It is West Virginia’s largest healthcare system and largest private employer with more than 2,500 licensed beds, 4,900 providers, approximately 30,000 employees, and more than $5 billion in total operating revenues. It includes: • J.W. Ruby Memorial Hospital in Morgantown (flagship), including WVU Medicine Children’s in Morgantown and Fairmont Medical Center in Fairmont; • United Hospital Center in Bridgeport; • Camden Clark Medical Center in Parkersburg; • Berkeley Medical Center in Martinsburg; • Barnesville Hospital in Barnesville, Ohio; • Braxton County Memorial Hospital in Gassaway; • Garrett Regional Medical Center in Oakland, Maryland; • Harrison Community Hospital in Cadiz, Ohio; • Jackson General Hospital in Ripley; • Jefferson Medical Center in Ranson; • Potomac Valley Hospital in Keyser; • Princeton Community Hospital in Princeton, including The Behavioral Health Pavilion in Bluefield; • Reynolds Memorial Hospital in Glen Dale; • Saint Francis Hospital in Charleston; • St. Joseph’s Hospital in Buckhannon; • Summersville Regional Medical Center in Summersville; • Thomas Memorial Hospital in South Charleston; • Uniontown Hospital in Uniontown, Pennsylvania; • Wetzel County Hospital in New Martinsville; • Wheeling Hospital in Wheeling; • And five institutes – the WVU Cancer Institute, the WVU Critical Care and Trauma Institute, the WVU Eye Institute, the WVU Heart and Vascular Institute, and the WVU Rockefeller Neuroscience Institute. The WVU Health System also provides management services to Grant Memorial Hospital in Petersburg. For more information, visit WVUMedicine.org.
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Job description

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full.  Below, you’ll find other important information about this position. 

Help design and build a health plan from the ground up as an Intake Coordinator. Reporting to the Health Plan Manager of Utilization Review, the Intake Coordinator will be an integral member of the health plan’s medical management team. This team member will serve as the point-person for all inbound requests for utilization review from providers and pharmacies. The Intake Coordinator will utilize technology to push data to internal stakeholders for decision making.
The Intake Coordinator is a collaborative member of the Medical Management team

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High School diploma/GED

EXPERIENCE:

1. One (1) year of working in healthcare.

2. One (1) year of customer service experience.

 

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Associate Degree in related healthcare field.

EXPERIENCE:

1.Two plus years of healthcare and customer service experience

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

 

1. Obtains requests from providers via phone, fax, or provider portal.

2. Understands and utilizes software systems to determine member plans and requirements.

3. Builds the case in the utilization management system.

4. Determines cases that may require additional notification to the member, provider and/or pharmacist.  When needed, contact the member or provider by phone to obtain the information.

5. Ensures accuracy of data entry to prevent downstream errors.

 

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

 

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. Standard office environment

 

SKILLS AND ABILITIES:

1. Excellent written and oral communication

2. Problem solving capabilities to drive improved efficiencies and customer satisfaction

3. Attention to detail

4. Proficiency with Microsoft Office

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

PHH Peak Health Holdings

Cost Center:

2403 PHH Medical Management

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.
Are you interested?

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