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Job Details:
Position Name : Intake Specialist
Location: Spokane, WA
Job ID : 9817c4ec0949d0c0
Description : Together with our partners, Comagine Health works to improve health and create a better health care system so that people and communities will flourish.As a trusted, neutral party, we work with our partners to fix key, intractable health and health care delivery problems. In all our engagements and initiatives, we draw upon our deep expertise in quality improvement, care management, health information technology, analytics, and research and evaluation.We are looking for an Intake Representative.What you’ll be doing:Assist providers to submit documentation of requests for case management, utilization review, and other medical management services.Enter documentation of requests for case management, utilization review, and other medical management services (collect/enter information into the system that is limited to non-clinical data or is structured clinical data).Convey case information and other notifications via inbound and outbound calls.Validate the request submitted via the Comagine Health Provider Portal for accuracy and completeness.Screen cases for required medical information based on type of request, determining if information is sufficient for clinical reviewObtain clinical information from the client systems when indicated or contact provider to obtain information required for review.Determine based on training when a scripted review is indicated based on contract requirementsProcess requests after physician review, evaluating language and working with physician reviewers, clinical reviewers, or managers to ensure language and determination information is complete before sending letters to providersRespond to inbound telephone requests with clear documentation in the care management system of calls.Enter case information from original source documentation or validate information entered by providers in the portalMake courtesy calls with case reference numbers.Provide notification of completed review and additional information needed, when applicableContribute to orientation and training of other non-clinical employeesAs requested, create templates for complex reviews, perform internal quality reviews, and/or participate in provider outreach activitiesMay perform scripted clinical reviews and refer reviews requiring further action to clinical review staffAfter physician review, notify providers of decertification or potential denial of services by phone or in writing as required by contract.Complete case after physician review, returning to clinician or sending to client based on procedureAdded accountabilities when performing case management support (as appropriate) include but are not limited to:Arrange ancillary authorization requests such as transportation, accommodationObtain customer consent for care management services to be performedCorrespond with facilities, providers, and othersCoordinate non-clinical functions and intervention, as directedSupervised closure of cases upon completion of review by a clinical reviewer, as directedWe offer a competitive pay and benefits package plus employment with Comagine Health qualifies if you apply for the Public Service Loan Forgiveness (PSLF) Program!Required Experience:High school diploma or equivalentEquivalent combination of education and/or work experience in related field may be substitutedPreferredPost-secondary education or certification in a related field (preferred)2 years of related work experience or customer service experience1 year of work experience in healthcare2 years of work experience in healthcare; nursing assistant or medical assistant experience (preferred)Comagine Health’s mission is to work together with our partners to improve health and create a better health care system so that people and communities will flourish. As part of our mission and values, we recognize the importance of having our employees vaccinated against COVID-19- both as a protection for our larger community and to keep our employees and their families safe.As a federal contractor, and in compliance with Executive Order 14042, Comagine Health requires its employees and contractors to be fully vaccinated against COVID-19 (including any booster shots if required), unless they are approved for a reasonable accommodation based on medical condition or religious belief that prevents them from being vaccinated. Being fully vaccinated against COVID-19 is a condition of employment at Comagine Health.If you are fully vaccinated, you will be required to provide proof of your completed COVID-19 vaccination prior to the first day of your employment. Failure to provide timely proof of your COVID-19 vaccination status may result in your offer of employment being rescinded or your start being delayed.If you are unable to be fully vaccinated due to medical condition or religious belief, you will be required to request an exemption upon acceptance of the offer of employment. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an exemption is not approved, then your offer of employment may be rescinded.Job Type: Full-timePay: $18.00 – $20.00 per hourBenefits:401(k)401(k) matchingDental insuranceEmployee assistance programFlexible spending accountHealth insuranceHealth savings accountLife insurancePaid time offReferral programVision insuranceSchedule:8 hour shiftApplication Question(s):Do you currently reside in the state of Washington?Experience:Microsoft Office: 1 year (Preferred)Healthcare: 2 years (Preferred)Work Location:Fully Remote
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