Wellmark Blue Cross and Blue Shield

Intake Specialist

• Facilitate care management functions in a call center setting
• Verify member eligibility and benefits
• Verify provider participation and network status
• Process eligibility, authorization status inquiries, data collection, documentation, precertification, and notification requests
• Provide administrative support to care management teams
• Document information received by phone, fax, or provider portal in JIVA
• Manually create episodes for services and admissions for Nurse Care Manager medical-necessity review
• Create and send letters to providers and members communicating authorization request outcomes
• Manage workload within regulatory turnaround requirements and mandated processing timeframes
• Provide accurate information using current guidelines and job aids
• Meet Health Services quality assurance and production metrics
• Interpret and comply with regulatory, accreditation, HIPAA, Health Services, and internal standards
• Perform other duties as assigned

Explore Health Services Intake Specialist – Remote eligible after… at Wellmark Blue Cross and Blue Shield. Review requirements and application details.

Health Services Intake Specialist – Remote eligible after onsite training