Intake Coordinator

• Respond to provider requests telephonically and electronically for preauthorization of inpatient admissions and outpatient services and procedures
• Verify benefits, eligibility, and provider network status
• Promote and maintain a positive company image through telephonic and electronic contact with internal and external customers
• Meet staff and unit performance targets and departmental productivity goals
• Receive member clinical data, enter relevant case information, and follow departmental processes to authorize services
• Forward cases and clinical data to the appropriate Utilization Review team when approval is not allowed by process
• Manage authorizations to minimize healthcare disruption, standardize decision timeliness, and accommodate provider/member needs
• Manage verbal notifications and written materials in compliance with regulatory and operational guidelines
• Maintain knowledge of lines of business, laws and regulations, data exchange code sets, medical terminology, computer systems, Care Management and URAC policies and procedures
• Complete special assignments and projects requested by management
• Comply with laws and regulations associated with job duties
• Perform other job-related duties within the scope of responsibilities