Utilization Review Intake Specialist

Virgin Pulse; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

Join a forward-thinking company that is revolutionizing health engagement! This role is vital in supporting the utilization management division, where you will perform clerical and administrative duties, manage customer inquiries, and assist with data entry. You will thrive in a fast-paced environment, utilizing your strong communication skills and attention to detail. This innovative firm offers a collaborative culture and is committed to diversity and inclusion, ensuring every voice matters. If you are passionate about making a difference in health and wellbeing, this is the opportunity for you!

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Mental Health Benefits

Qualifications

• Experience in customer service and/or medical background is essential.
• Strong written and verbal communication skills are required.

Responsibilities

• Perform clerical duties in the utilization management division.
• Answer and route incoming phone calls and provide information.

Skills

Customer Service

Communication Skills

Data Entry

Microsoft Excel

Microsoft Word

Microsoft Outlook

Medical Terminology

ICD-10 Coding

CPT Coding

HCPCS Coding

Education

Associate Degree in Business

Management Degree

Job description

Overview

Now is the time to join us!

We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Responsibilities

Who are you?

Perform clerical/administrative duties in the utilization management division.

In this role you will wear many hats, but your knowledge will be essential in the following:

• Answer and route all incoming phone calls.
• Provide accurate information to internal and external customers regarding pre-certification process, including gathering demographic, non-clinical, and/or provider data for pre-certification via phone, fax, inter/intranet, and various computer software programs.
• Review service requests and manage the requests as efficiently as possible involving the appropriate department as needed.
• Perform data entry and maintain complete documentation of case information; assist in document maintenance or revisions; compile monthly reports; maintain logs and files.
• Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Qualifications

What you bring to the Personify Health team:

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

• Prior experience in customer service and/or medical background.
• Prior insurance and/or claims background.
• Prior experience in a medical front office or hospital patient intake, medical claims processing, or an equivalent combination of education and experience.
• Associate degree preferred in business, management, or related field.

You also take pride in offering the following Core Skills, Competencies, and Characteristics:

• Strong written and verbal communication skills.
• Ability to manage high volumes of customer service calls.
• Proficient in Microsoft Excel, Word and Outlook.
• Ability to organize, prioritize, and multitask in a fast-paced/deadline driven environment.
• Demonstrate ability to work independently with excellent judgment.
• Accurate data entry skills (40wpm).
• Knowledge of medical terminology; ICD-10, CPT & HCPCS coding desirable.

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $16 to $18 per hour. Note that compensation may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

Application Deadline: Open until position is filled.