Intake Coordinator II
New Century Health is leading transformative change in specialty care management. By combining medical management expertise with a deep understanding of healthcare informatics, physician management and healthcare technology systems development, we generate insights that drive leading edge and effective innovation. What does this mean to you? It means that when you join us, you will be a key contributor to one the fastest growing healthcare services in the National Oncology and Cardiology care management space today. With your knowledge, skills and abilities, you will impact the delivery of care and directly contribute to our ability to positively impact and meet the critical unmet needs of patients suffering from all types of cancer.
We support our employees with an outstanding benefit package that features programs like employee paid medical benefits, 100% match on your 401k contribution up to 4% of your base salary, generous tuition reimbursement, as well as above average paid time off. If you are interested in working with some of the most dedicated, passionate and smartest people on the planet, express your interest in speaking with us and we will respond immediately.
The Intake Coordinator II (IC II) reports to the Supervisor - Intake Services. The IC II is a non-clinical staff member responsible for reviewing requests for completeness of information, collection and data entry of clinical information into the New Century Health Information System based on structured algorithms. The IC II is responsible for generating authorization and adverse determination letters once such determination is rendered by clinical personnel, and responding to provider inquiries. The Intake Coordinator II is responsible for all documentation and initial processing of an authorization request.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Responsible for incoming and outgoing calls regarding authorization request status, office referrals, eligibility, and general inquiries
- Manages the Utilization Management phone queues during business hours
- Provides effective customer service to our clients by appropriately responding to emails, phone calls and/or any communication regarding requested information
- Performs notification of medical necessity determinations in accordance with departmental policies, regulatory requirements, and client contractual agreements
- Enters structured clinical data (including patient and provider demographics, HCPCS codes, JCODES, etc.) received via phone, fax, and/or online web portal into New Century Health’s online clinical system
- Reviews authorization requests received via phone, fax, and/or online web portal for completeness of information
- Accurately documents information received from members, physician’s offices, and health plan clients into New Century Health’s online clinical system
- Processes authorization requests in accordance with departmental policies, regulatory requirements, and client contractual agreements
- At the direction of appropriate clinical staff, may contact the physician’s office or patient for additional information
- Creates and generates reports using Microsoft Office, and/or New Century Health’s computer based programs
- Performs clerical duties such as faxing and scanning documents, filing clinical into patients electronic chart, creating shipping labels, preparing letters and parcels using office machines, such as printers, photocopies, scanners, facsimile machines, telephone and voice mail systems and computer based programs such as Microsoft Office
- Supports UM functions by performing activities that do not require evaluation or interpretation of clinical information
- Assists in completing daily tasks by participating in meetings and working closely with the management team and UM clinical staff
- Acts as an interdepartmental liaison between all New Century Health offices, departments, and committees
- Maintains consistent attendance in order to meet UM daily performance goals
- Acts with honor and integrity, serving as a role model for the company
- Respects and maintains HIPAA and PHI confidentiality guidelines
- Performs other duties as assigned
EDUCATION and/or EXPERIENCE:
- A high school diploma or GED and 2 to 5 years of relevant Health Care experience in a call center or prior authorization environment utilizing the telephone and computer consistently.
- Or a graduate of an accredited pharmacy technician program with minimum 1 year of relevant experience in a pharmacy or prior authorization environment.
OTHER SKILLS and ABILITIES:
- Familiarity with computer and Windows PC applications which includes the ability to learn new and complex computer system applications.
- The ability to navigate a computer while on the phone.
- The ability to multi-task including the ability to understand multiple services and products
- Excellent attendance with the ability to meet a demanding but flexible work schedule.
- Excellent communication skills and telephone etiquette. The ability to pass Proficiency testing.
- Bilingual in Spanish preferred.
- Able to work in a fast-paced environment, demonstrate excellent problem solving, critical thinking, and organizational skills.
- Must have exceptional attention to detail and perform consistent work product validation/QA.
- Self-motivated, self-directed, team oriented, and responsible, with a positive attitude and a proactive style. Possesses the ability to operate in a highly variable work environment.
- Presents a courteous and competent demeanor to our clients and teammates.