Medical Management Intake Specialist

State of Michigan BH (SOM BH) Audit provider outreach, Provider Data Confidence Value (PDCV) audit provider outreach, return mail, facility attestation noncompliant providers, daily CAQH Directory Verification task. Perform several outreaches daily to providers across Michigan to verify certainty of demographic information such as phone numbers, address, accepting new patients.

Our client, a Health Insurance company, is looking for a Medical Management Intake Specialist for their Detroit, MI/Hybrid location.
 
Responsibilities:

• The original scope for bring specialist onboard is to work on PIAI projects provider data clean up measures. 
• Upon completion of projects, we are finding that these projects are turning into ongoing processes.
• Validating provider information through auditing processes to reduce and eliminate inaccurate data for accuracy and auditing purposes.
• Increase provider accuracy on members website by eliminating outdated information.
• Perform several outreaches daily to providers across Michigan to verify certainty of demographic information such as phone numbers, address, accepting new patients.
• Review and process results of audits for validity in collaboration with leadership to ensure accurate data is uploaded into database.

 
Requirements:

• High school dipolma
• 3 to 5 years experience
• For example:
• State of Michigan BH (SOM BH) Audit provider outreach, Provider Data Confidence Value (PDCV) audit provider outreach, return mail, facility attestation noncompliant providers, daily CAQH Directory Verification task.
• The rest of the required skills/experience:
• Excel
• Access
• Outlook
• Preferred Skills/Experience:
• Optional but preferred skills/experience:
• Include:
• Portico
• SF Macess
• Facets

 
Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities