Healthcare Intake Specialist SWHR CIN

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Strategic Services
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20006789 Requisition #
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Southwestern Health Resources (SWHR CIN) seeks to hire a Healthcare Intake Specialist to work Full Time supporting the Utilization Management department.

 

Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern.  If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee.

 

The address is 900 Jerome Street, Fort Worth, Texas 76104 in the Midtown Medical Center.

 

Salary range is Min $14.85 - Max $20.40 – based on relevant experience

 
 

Work Schedule

Monday-Friday 8am-5pm

 

Job Description

Performs high level of data entry.

Follows standard operating procedures for updating authorizations, including precertification and IP notifications in Care Managements software.

Meets any intake production or QA metrics.

Responsible for processing, entering, triaging and routing all precertification and referral requests.

Ensures the overall data integrity of documents received and entered into computer system.

Responsible for following non-clinical algorithms, network tier structure/exceptions, and precertification and referral requirements by health plan for initial organization determinations and referrals.

Responsible for following all compliance and regulatory requirements for turn-around time, notification to provider/member, and accuracy/completeness.

Supports UM/UE Clinical staff in obtaining clinical information and status of requests.

Supports CM Clinical staff in processing referrals to the care management program.

Responsible for supporting any assigned special projects pertaining to UM/UE functions, customer service, and care management.

Responsible for outreach to providers to obtain necessary information to process precertification and referral requests.

Consistently meets performance standards of production, accuracy, completeness and quality.

Handles volume of inbound and outbound phone calls with excellent customer service as needed.

Updates Care Management appropriate wrap-up codes, break/lunch codes and any other codes for accurate and complete reporting when handling volume of inbound phone calls.

Communicates actively and routinely with management team, and staff in handling client services, issues, escalated referral and preauthorization questions.

Manages fax server, online requests and phone inquiries and processes requests from each.

Secures patient demographics, verify benefits, and requests and enters clinical history as needed.

Uses interpersonal/communication strategies with individuals to achieve: (a) desirable/acceptable outcomes/responses (b) perceptions of satisfaction or acceptance of those involved.

Perform procedures required by the assignment: (a) safely, without causing harm (b) effectively, achieving the intended outcome/result (c) efficiently, using the fewest possible resources (d) legally, within the scope of practice/policy.

Establishes and/or revises priorities based on: (a) urgency of the patient or organization’s needs (b) resource availability (c) predetermined schedules (d) other departments/personnel expectations.

Competes all compliance, regulatory and process training within the specified timeline.

 

The ideal candidate will possess the following qualifications:

 

Education
High School Diploma or Equivalent Required
Associate's Degree Preferred

 

Experience
2 years Full-Time Medical Referrals and Preauthorization Experience in a Healthcare Setting Required
2 years Customer Service Experience Required


Skills
High level experience in data entry with accuracy.

Excellent typing skills.
Excellent phone etiquette.

Ability to provide "customer service focus."

Work requires ability to communicate effectively with various levels of internal and external contacts.

Work requires ability to work with confidential information on daily basis.

Interpersonal and teamwork skills to contribute to objectives of organization.

Adaptability/flexibility to react positively to changes in work environment.

Initiative to improve productivity and quality of work.

Knowledge of specific regulatory, Managed Care requirements.

Must be proficient in various word processing, spreadsheet, graphics, and database programs including Microsoft Word, Excel, Access, PowerPoint, Outlook, etc.

Working knowledge and ability to apply professional standards of practice in work environment.

 

Supervision
Individual Contributor

ADA Requirements
Working Indoors 67% or more

Physical Demands
Sedentary

 

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