Non-Clinical Intake

Community Health Network of Connecticut, Inc; Wallingford, Northern (CT, KY); Hybrid; USD 37,000 - 40,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Flexible spending and health savings

Group term life insurance

401(k) plan with company-match

Voluntary accidental injury coverage

Tuition reimbursement and continuing教育

Paid leave and holidays

Wellness program

Job summary

Community Health Network of Connecticut, Inc. (CHNCT) seeks a Non-Clinical Intake Representative to support the Utilization Management Unit in Wallingford, CT.

Primary responsibilities include triaging incoming calls, entering referrals, and coordinating information for medical necessity determinations. The role involves reviewing referrals for completeness, verifying eligibility and network status, and assisting with provider appeals.

Qualifications

• Excellent interpersonal/telephone communication skills.
• Knowledge of medical terminology, ICD9 and CPT 4 coding.
• Strong word processing and data entry skills.
• Ability to handle several tasks concurrently.
• Claims processing background preferred.

Responsibilities

• Responds to telephonic requests by providers for authorization and benefit coverage for CHNCT members for all lines of business.
• <b>Note:</b> Approves services based on benefit package.
• Performs data entry for specialty visits, rehabilitation, DME, etc. Interacts with providers and vendors to collect necessary medical information and office notes needed to support clinical staff in decision making.
• Identifies service requests for non-par providers and services outside of member benefit packages and refers to clinical staff.
• Reviews referrals for completeness, verifies eligibility and verifies that provider is in network. Assists with entry of new hospital admissions.

Skills

Interpersonal communication

Data entry

Medical terminology

ICD9 & CPT coding

Education

High school diploma or GED

Tools

Word processing

Claims processing software

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Non-Clinical Intake

Agency Full Time Temporary Medium Wallingford, CT, US 1 Attachments

Salary Range: $37,440.00 To $39,520.00 Annually

Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Non-Clinical Intake Representative.

Important: This position will be filled through selected staffing agencies. Please be sure to indicate the staffing agency that you are working with on your application.

Primary Responsibilities:

• Responsible for triaging all incoming calls into the Utilization Management Unit, entering referrals into system, requesting all clinical information and forwarding any referral requiring medical necessity determination to clinical staff.
• Provides support for claim related provider appeals.

Tasks Performed:

• Reviews all referrals for completeness, verifies eligibility and verifies that provider is in network. Assists with entry of new hospital admissions.
• Maintains knowledge of covered benefits of Medicaid programs.
• Identifies and refers for coordination of benefits (COB) and third-party liability (TPL) as appropriate.
• Maintains confidentiality of member specific records.
• Acts as preceptor to new staff.
• Performs other duties as assigned.

Essential Functions:

• Responds to telephonic requests by providers for authorization and benefit coverage for CHNCT members for all lines of business.
• Approves services based on benefit package.
• Performs data entry for specialty visits, rehabilitation, DME, etc. Interacts with providers and vendors to collect necessary medical information and office notes needed to support clinical staff in decision making.
• Identifies service requests for non-par providers and services outside of member benefit packages and refers to clinical staff.

Desired Education: Secondary schooling

Desired Degree: High school diploma or GED

Desired Experience: 1 to 3 years' related experience

Other Qualifications: Claims processing background preferred. Excellent interpersonal/telephone communication skills. Knowledge of medical terminology, ICD9 and CPT 4 coding. Strong word processing and data entry skills. Ability to handle several tasks concurrently.

• Medical, dental and vision coverage options
• Flexible spending and health savings accounts
• Group term life insurance
• A 401(k) plan with company-match and immediate vesting
• Voluntary accidental injury coverage
• Tuition reimbursement and continuing education opportunities
• A generous paid-leave bank and company holidays
• Wellness program

We are dedicated to having a workplace where everyone feels valued, respected, and empowered to succeed. We embrace a wide range of perspectives and backgrounds, ensuring fair treatment and opportunities for all employees. We value our team’s rich array of experiences and viewpoints, which contribute to our innovative and collaborative environment.

We are committed to providing an inclusive and accessible interview process. If you require a reasonable accommodation for your interview due to a disability. Please contact us in advance if you need an accommodation.

Attachments (1)

Non-Clinical Intake (AD148) 03.26.2024.pdf