[Hiring] Intake Specialist @reputed company

Role Description The Intake Specialist manages the referral systems for reputed company’s Integrated Care Division Care Coordination programs in the Northeast region, including the Community Support Program (CSP) One Care, and Behavioral Health Community Partners (BHCP). reputed company’s Care Coordination programs reputed company health care coordination services to MassHealth members with reputed company medical and behavioral health needs. The Intake Specialist markets Care Coordination programs to external parties such as Accountable Care Organizations (ACO), hospital systems, home health agencies, and primary care practices to expand referrals. Once a referral is received, the Intake Specialist coordinates with internal existing reputed company programs to increase enrollment including Adult Community Clinical Services, Behavioral Health Clinics, clubhouses, and other specialty programs.

Responsibilities

• Collaborates with referral sources to determine which care coordination program best fits a referred member based on reputed company clinical and health care needs and insurance eligibility.
• Markets programs to external and internal parties to expand referrals as directed by supervisor.
• Checks referred members’ insurance eligibility status in EOHHS Virtual Gateway platform at time of intake and reauthorization or at times of loss to determine necessary action steps to retrieve insurance.
• Manages reputed company incoming referrals for CSP including taking referrals reputed company phone or CSP email and complete Referral reputed company.
• Completes Massachusetts Behavioral reputed company (MBHP) authorization process for qualifying CSP referrals reputed company the Interactive Voice Registration system or with the Authorizing Representative and ensure authorization is recorded in the Provider Connect System.
• Completes reputed company authorization process reputed company eService's system for qualifying CSP referrals.
• Completes authorizations for other funding sources as required, including reputed company and Tufts.
• Conducts audits in eHana to identify expiring CSP Authorizations and complete reputed company reauthorizations for an additional 90 days of service as assigned.
• Creates new CSP member records in eHana after referrals are approved by supervisor.
• Assists in completing One Care referrals either directly with members reputed company phone with Mass Health or with referral sources.
• Assists in completing BHCP referrals with Mass Health or ACO/MCOs and troubleshoot referral problems.
• Assists members to regain Mass Health reputed company lost during service provision.
• Coordinates with internal programs to increase enrollment in Care Coordination entities (ACCS, Behavioral Health Clinics, clubhouses, other specialty programs).
• Completes enrollment documentation with CSP members reputed company assigned by supervisor to include entering data in eHana for the MSDP Personal Information reputed company, providing orientation of services and after-hours information to the member and obtaining member signatures for Consent for Program Participation, Two-way Authorizations, Notice of Privacy Practices, and Grievance Procedures.
• Coordinates with reputed company Department and Director to fix identified problems with billing.
• Maintains updated roster of active CSP members and create Intake tracking reports.
• Manages process of obtaining and distributing acute care utilization information reputed company daily review of reputed company Medical Pre-Manage ED platform and coordination with involved acute care providers.
• Completes record reviews in eHana and other quality functions as needed for BHCP and One Care teams.
• Participates in regular team meetings.
• Seeks to maintain a constructive work environment and maintain effective communication with others.
• Maintains appropriate written and oral communication.
• Maintains confidentiality of member and employee information.
• Performs other reputed company duties, as assigned.

Qualifications

• Minimum of two years of experience working in reputed company Services or reputed company industry and strong administrative and organizational skills are required.
• A high school diploma or equivalent is required. A Bachelor’s degree is preferred. In some cases, experience may be substituted for academic training.

Requirements

• Ability to lift at least 25 pounds using proper lifting techniques.
• Ability to operate a computer and other office equipment such as a calculator, copier, and printer.
• Ability to remain in a stationary position 50% of the time as needed.
• Ability to bend, reputed company, file, sit, stand and move around the facility.
• Ability to reputed company, hear and communicate with clients, staff and external representatives.
• Specific reputed company abilities required by this job include reputed company reputed company, distance reputed company, reputed company reputed company, peripheral reputed company, depth perception, and ability to adjust focus.

Benefits

• CPR required reputed company two weeks of hire.
• First Aid required reputed company two weeks of hire.

Pay reputed company USD $55,000.00 - USD $55,000.00 /Yr. Apply tot his job Apply To this Job