Remote Intake Coordinator for Healthcare Referrals

Guidehealth; Chicago (IL); Remote; USD 28,000 - 29,000; Full time

Benefits offered by this job

Work from Home

Medical, Dental, Vision plans

401(k) with employer match

Paid time off

Parental leave

Employee Assistance Program

Job summary

Guidehealth is seeking an intake coordinator to review and approve routine referrals and pre-certifications for our Blue Cross HMO program. The role combines clerical tasks with strict adherence to healthcare guidelines and privacy standards.

You will screen complex referrals, enter data using ICD-10/CPT, support provider offices, and collaborate with Clinical Services to ensure timely authorizations. Fully remote role with competitive hourly pay.

Qualifications

• Prior experience in a healthcare setting.
• Strong knowledge of HMO.
• Knowledge of Excel basic function and PDF Converter and/or Adobe Pro.
• Must be organized and task oriented.
• Strong time management skills.
• Ability to work independently.

Responsibilities

• Initiating pre-review screening on complex referrals and/or pre-certifications and submitting to the Clinical Services Department for review and finalization.
• Screens potential denials and submits to the Clinical Services Department.
• Providing clerical support with computer entry, in-coming and out-going phone calls.
• Entering of referral and pre-certifications complying with multiple sets of protocols which are built in the application.
• Maintaining and managing strict confidentiality of all information related to health care services.
• Entering referrals and precertifications into software using ICD-10 and CPT coding and following guides to meet requirements.
• Answering phone calls and making phone calls.
• Accurate and timely review of referral and pre-certifications authorizations.
• Assisting physician offices with referral and precertification questions.
• Working with Provider Relations and Claims staff to clarify discrepancies between referrals, precertifications and claims.
• Assisting Nursing staff in the development and maintenance of internal referral manuals.
• Adhering to all audit procedures.
• Performing other duties as assigned.

Skills

Healthcare experience

HMO knowledge

Excel basics

PDF Converter

Adobe Pro

Organized

Time management

Independent work

Tools

Excel

PDF Converter

Adobe Pro

Job description

Guidehealth is seeking an intake coordinator to review and approve routine referrals and pre-certifications for our Blue Cross HMO program. The role combines clerical tasks with strict adherence to healthcare guidelines and privacy standards.

You will screen complex referrals, enter data using ICD-10/CPT, support provider offices, and collaborate with Clinical Services to ensure timely authorizations. Fully remote role with competitive hourly pay.