The CSI Companies is currently seeking a Medical Intake Coordinator for a long-term contract position with one of our clients in San Antonio, Texas. This is a great opportunity to join an expanding team with one of the largest Physician led, patient centered healthcare system in the state of Texas!
All candidates must complete and pass a Background check, drug screening, and other health screenings if required.
Our benefits package includes weekly pay, direct deposit availability, multiple healthcare plans to include vision, dental, disability options, 401K and holiday and paid time off.
SCHEDULE: 9am-6pm Monday-Friday and the hours of 8am-5pm on rotating weekends and holidays.
This position is responsible for the daily coordination of UM processes in the Intake Call Center. This position serves as the initial intake of pre-service requests, claim reviews and inpatient hospital coordination and diabetic supplies. Coordinates UM processes with Medical Directors, UM Nurses, hospitals, physicians and other various departments. Provides clerical support to clinical staff in their medical necessity review process. UM Coordinator is expected to maintain production and quality standards.
- Managing authorizations/notifications and other service requests received via incoming high volume phone calls, faxes and portal submission
- Providing excellent customer service, including the ability to handle escalated callers.
- Determining authorization or notification requirements
- Preparing authorization cases for Medical Directors, UM Nurses and Case Managers
- Handling expedited authorizations, authorization updates and status checks
- Confirming member eligibility
- Responsible for outreaches to providers and/or Patient to complete authorization requests and prescriptions.
- Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
- Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task.
- Non-Clinical staff is not responsible for conducting any UM activity that requires interpretation of clinical information.
Minimum Required Education, Experience & Skills:
- 1 or more year’s previous related experience in any of the following or combination thereof: healthcare, call center, and/or customer service setting using the telephone and computer as the primary instrument to perform job duties.
- Medical Terminology, ICD-9/ICD-10 and CPT Knowledge.
- Proficiency with Microsoft Office applications required, i.e Excel, Access, Outlook
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