Behavioral Health - Intake Specialist 150-1005
CommunityCare
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- Location
- Tulsa, OK
- Work style
- On-site
- Job type
- Contractor, Temporary
- Posted
- Oct 5
- 15 days ago
Career path
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About the company
CommunityCare
Insurance · 201 to 500 employees
What you'll do
- Supports behavioral health benefit inquiries, directs members to in-network services, processes prior authorizations, and resolves calls.
- Handles referrals, eligibility verification, documentation, provider faxes, member letters, claims-related tasks, and other administrative work.
What you need
- Requires a high school diploma or equivalent and successful completion of a Health Care Sanctions background check.
- Customer service, office management, or healthcare experience is preferred but not required.
- Education: a high school diploma
Key skills
Microsoft applicationsMulti-taskManage time efficientlyWork independentlyGood judgmentOral communication skills
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JOB SUMMARY:
Responsible for providing customer service support for behavioral health benefits, directing members to appropriate in network services, processing prior authorizations according to CMS and State regulations, sending out provider faxes well as member letters, and resolving behavioral health related situations that arise from calls.
KEY RESPONSIBILITIES:
Available and able to be telephone support from 8AM -5PM except for lunch and breaks to support behavioral health needs for all lines of business.
Provides resolution for various types of phone calls including, but not limited to referral, authorization, and verifying member eligibility, line of business and network affiliations for members and providers.
Determines if the call is clinical and requires transfer to a clinical staff person. Will inform callers, including members, facility personnel, physicians, or other health care professionals of the utilization requirements and procedures.
Makes initial referrals that do not require evaluation or interpretation of clinical information to behavioral health services. Completes appropriate electronic certification and progress notes documentation of activities as needed.
Assists with specialized job tasks which may include claims corrections and follow-up with provider/member questions regarding claims payments, generate provider faxes, generate member letters, and other administrative tasks.
Work may also involve dealing with members who are disgruntled or upset.
Performs other duties as required.
QUALIFICATIONS
:
Basic punctuation and grammar skills
Ability to multi-task and manage time efficiently.
Proficient in Microsoft applications.
Ability to work independently and apply good judgment.
Ability to maintain and preserve information of highly confidential nature.
Possess strong oral communication skills.
Successful completion of Health Care Sanctions background check.
EDUCATION/EXPERIENCE:
High school diploma or equivalent.
Customer service, office management, and/or healthcare experience preferred but not required.