Cds Intake Speciallist

Description:

First point of contact for network providers, physicians, and members. Responsible for processing incoming prior-authorization requests via phone, fax and web while ensuring that both internal and external customers receive a level of service that exceeds their expectations. Intake Specialist will utilize two methods of communication (inbound and outbound) calls and written correspondence. Must respond to and resolve questions and problems from network providers, imaging centers/facilities, members, and referring providers. Intake Specialist also receives inbound calls on follow-up to existing authorization request either in process or processed.

Key Responsibilities
 

• Receive/process authorization request intake via phone, fax and/or web
• Collect and transfers non-clinical data
• Acquire structured clinical data
• Review authorization request for completeness of information
• Verify eligibility
• Verify physician and rendering facility participation
• Initiate an online authorization based on information received
• Submit cases for second level review if medical necessity cannot be established
• Provide customer service to callers following-up on existing authorization request either in process or processed
• Perform functions according to client program design
• Perform other duties/functions as director from Supervisor
   

Required Qualifications

Work Experience:

Years of Applicable Experience - 0 or more years

Education:

High School Diploma or GED (Required)

Preferred Qualifications

Skills:
 

• Data Entry
• Customer service
• Detail oriented
• Strong written and verbal skill
   

Experience:
 

• 1 year of applicable experience (e.g. prior experience in medical, healthcare, and/or contact center setting)
   

Education:
 

• High School Diploma or GED
   

Additional Job Requirements:
 

• Remain in a stationary position for prolonged periods of time
• Be adaptive and change priorities quickly; meet deadlines
• Attention to detail
• Operate computer programs and software
• Ability to communicate effectively with audiences in person and in electronic formats.
• Day-to-day contact with others (co-workers and/or the public)
• Making independent decisions
• Ability to work in a collaborative business environment in close quarters with peers and varying interruptions