Behavioral Health Intake & Authorization Specialist

CommunityCare, Inc.; Tulsa, Northern (OK, KY); Hybrid; USD 32,000 - 42,000; Full time

Job summary

CommunityCare, Inc. in Tulsa, OK is seeking an Intake Specialist to support behavioral health benefits and direct members to in-network services.

The role processes prior authorizations in accordance with CMS and state regulations, sending out provider faxes and member letters, and resolving related situations arising from calls. The position involves handling calls from 8AM to 5PM, triaging clinical versus non-clinical inquiries, and performing related administrative tasks with confidentiality

Qualifications

• High school diploma or equivalent.
• Customer service, office management, and/or healthcare experience preferred but not required.

Responsibilities

• Available for telephone support 8AM–5PM, with breaks for lunch and rest to support behavioral health needs.
• Resolve various call types including referrals, authorizations, and verifying member eligibility.
• Determine if calls are clinical and transfer to clinical staff when needed; inform callers of utilization requirements and procedures.
• Make initial referrals to behavioral health services and document activities with electronic notes as needed.
• Assist with tasks such as claims corrections, provider/member questions about claims payments, and generating provider faxes and member letters.
• Handle interactions with upset or disgruntled members.
• Perform other duties as required.

Skills

Customer service

Healthcare background

Oral communication

Confidential data handling

Time management

Independent work

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

CommunityCare, Inc. in Tulsa, OK is seeking an Intake Specialist to support behavioral health benefits and direct members to in-network services.

The role processes prior authorizations in accordance with CMS and state regulations, sending out provider faxes and member letters, and resolving related situations arising from calls. The position involves handling calls from 8AM to 5PM, triaging clinical versus non-clinical inquiries, and performing related administrative tasks with confidentiality