Clinical Intake Analyst Specialist in Boise, Idaho

Boise, Idaho

Contract/Temp to Hire


LHH is seeking a Clinical Intake Analyst who can confidently and independently work from home and demonstrate a strong work ethic. The Clinical Intake Analyst I acts as the initial point of receipt for all incoming work for the Clinical Service Operations teams.

Location: Remote - Candidates MUST be in one of the four states in which the client operates: Oregon, Washington, Idaho or Utah.

Ideal Candidate
  • Ability to work remotely (Full time) to work weekends/holidays/past 5:00 PM
  • Ability to work overtime when needed
  • Be able to explain EOBs effectively, explain insurance benefits, understanding of prior authorizations, and insurance verification
  • Demonstrated knowledge of medical terminology, coding, and healthcare insurance
  • 2 years of experience in Regence Customer Service or equivalent combination of education and experience.
Connectivity Requirement: Computers can only connect through the following types of Internet Service Providers (ISPs): CATV/Cable Modem, DSL or Fiber. Client does NOT support Satellite or mobile WIFI internet connectivity. SKILLS & ABILITIES:
  • Effective communication and writing skills.
  • Strong customer service skills, including listening, patience, empathy, maintaining confidentiality, and focus on meeting customer needs.
  • Intermediate computer skills (e.g., Microsoft Office, Outlook, Internet search) and experience with health care systems and documentation (EMR, billing and claims).
  • Strong organization, data entry, and administrative skills. Demonstrated knowledge of medical terminology, anatomy and coding (CPT, DX, HCPCs).
  • Ability to investigate and research issues related to clinical programs and work with clinical staff to resolve them.
  • Ability to work independently, to prioritize work, meet deadlines and achieve operational standards.
  • Ability to work effectively in a team environment. Ability to perform job duties and responsibilities for a Clinical Intake & Correspondence Specialist I.
  • Ability to research complex inquiries and coordinate with appropriate staff to complete work.
  • Strong business writing skills and ability to compose written responses to members or providers.
  • Ability to mentor and support co-workers and provide training to new team members.
  • Normally to be proficient in the competencies listed above:
EDUCATION/QUALIFICATIONS
  • High school diploma or GED, and at least 1 year experience as a Clinical Intake & Correspondence Specialist I or equivalent combination of education and experience.
  • Demonstrated knowledge of medical terminology, anatomy, and coding
  • Previous professional experience in health insurance or provider’s office (scheduling, front office, etc.)
DUTIES & RESPONSIBILITIES
  • Adheres to dependability, customer focus, and all performance criteria as established by the department including timeliness, production, and quality standards for all work.
  • Utilizes knowledge and understanding to research simple to moderately complex documentation and requests related to UM processes and requirements, and CM and DM programs from members, providers, employer groups, agents, member representatives and internal customers.
  • Reviews requests for completeness of information and identifies additional information needed to initiate the request and asks for it when appropriate but does not perform any activities that require evaluation or interpretation of clinical information.
  • Validates preauthorization requirements, member benefits, eligibility, and documents information in the appropriate system.
  • Identifies errors promptly and determines what corrective steps may be taken to resolve errors.
  • Creates cases for UM, CM, DM in the Care Management System as appropriate.
  • May administratively authorize services as directed by Clinical Services Management.
  • May coordinate case information in external vendor systems for Medical Director Reviews, as necessary.
  • Receives medical inpatient admission and discharge notifications, and documents admission and discharge notifications as necessary for UM and CM use.
  • Coordinates reviews with members, providers, clinical staff, other departments, and vendors in order to process the request and provide a complete response, as necessary.
  • Follows strict guidelines to ensure all work meets corporate standards for accuracy, timeliness, quality and compliance with federal, state, BCBSA and accreditation regulations.
  • Organizes and keeps readily accessible all reference documents, policies and procedures needed to accomplish this.
  • Facilitates the member's or provider's understanding of the preauthorization process and of the information necessary to effectively process a preauthorization, as needed.
  • Utilizes knowledge and understanding to research difficult or complex documentation and requests related to UM processes and requirements, and CM and DM programs from members, providers, employer groups, agents, member representatives and internal customers.
  • Draft written notifications in compliance with all regulatory and quality entities to members and providers to request medical records and additional information, and communicate UM determinations, cancellations, and other necessary communications.
  • Tracks and monitors individual timeliness of UM reviews to ensure all Regulatory and Quality timeliness requirements are met.
  • Acts as a role model for other specialists; demonstrates and promotes an ethical work environment with internal and external contacts.
  • Assists with coaching, mentoring, and training, as directed by Supervisor.
  • Helps to answer questions for all levels of staff. Performs detailed research and problem-solving using sound decision-making skills after thoroughly researching the facts.
  • Participates in quality activities, task forces or work groups, or other training and/or process improvement teams.
  • Assumes a leadership role in identifying areas for improving the systems necessary to perform work and make appropriate recommendations.
  • May assist with systems testing if applicable.

$19-22 DOE


Location: Remote - Candidates MUST be located in one of the four states in which the client operates: Oregon, Washington, Idaho or Utah.


Equal Opportunity Employer/Veterans/Disabled


To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy


The Company will consider qualified applicants with arrest and conviction records

RefUS_EN_27_843297_2968575

Clinical Intake Analyst Specialist

LHH

4 days ago

Contract/Temp to Hire

Boise, Idaho


LHH is seeking a Clinical Intake Analyst who can confidently and independently work from home and demonstrate a strong work ethic. The Clinical Intake Analyst I acts as the initial point of receipt for all incoming work for the Clinical Service Operations teams.

Location: Remote - Candidates MUST be in one of the four states in which the client operates: Oregon, Washington, Idaho or Utah.

Ideal Candidate
  • Ability to work remotely (Full time) to work weekends/holidays/past 5:00 PM
  • Ability to work overtime when needed
  • Be able to explain EOBs effectively, explain insurance benefits, understanding of prior authorizations, and insurance verification
  • Demonstrated knowledge of medical terminology, coding, and healthcare insurance
  • 2 years of experience in Regence Customer Service or equivalent combination of education and experience.
Connectivity Requirement: Computers can only connect through the following types of Internet Service Providers (ISPs): CATV/Cable Modem, DSL or Fiber. Client does NOT support Satellite or mobile WIFI internet connectivity. SKILLS & ABILITIES:
  • Effective communication and writing skills.
  • Strong customer service skills, including listening, patience, empathy, maintaining confidentiality, and focus on meeting customer needs.
  • Intermediate computer skills (e.g., Microsoft Office, Outlook, Internet search) and experience with health care systems and documentation (EMR, billing and claims).
  • Strong organization, data entry, and administrative skills. Demonstrated knowledge of medical terminology, anatomy and coding (CPT, DX, HCPCs).
  • Ability to investigate and research issues related to clinical programs and work with clinical staff to resolve them.
  • Ability to work independently, to prioritize work, meet deadlines and achieve operational standards.
  • Ability to work effectively in a team environment. Ability to perform job duties and responsibilities for a Clinical Intake & Correspondence Specialist I.
  • Ability to research complex inquiries and coordinate with appropriate staff to complete work.
  • Strong business writing skills and ability to compose written responses to members or providers.
  • Ability to mentor and support co-workers and provide training to new team members.
  • Normally to be proficient in the competencies listed above:
EDUCATION/QUALIFICATIONS
  • High school diploma or GED, and at least 1 year experience as a Clinical Intake & Correspondence Specialist I or equivalent combination of education and experience.
  • Demonstrated knowledge of medical terminology, anatomy, and coding
  • Previous professional experience in health insurance or provider’s office (scheduling, front office, etc.)
DUTIES & RESPONSIBILITIES
  • Adheres to dependability, customer focus, and all performance criteria as established by the department including timeliness, production, and quality standards for all work.
  • Utilizes knowledge and understanding to research simple to moderately complex documentation and requests related to UM processes and requirements, and CM and DM programs from members, providers, employer groups, agents, member representatives and internal customers.
  • Reviews requests for completeness of information and identifies additional information needed to initiate the request and asks for it when appropriate but does not perform any activities that require evaluation or interpretation of clinical information.
  • Validates preauthorization requirements, member benefits, eligibility, and documents information in the appropriate system.
  • Identifies errors promptly and determines what corrective steps may be taken to resolve errors.
  • Creates cases for UM, CM, DM in the Care Management System as appropriate.
  • May administratively authorize services as directed by Clinical Services Management.
  • May coordinate case information in external vendor systems for Medical Director Reviews, as necessary.
  • Receives medical inpatient admission and discharge notifications, and documents admission and discharge notifications as necessary for UM and CM use.
  • Coordinates reviews with members, providers, clinical staff, other departments, and vendors in order to process the request and provide a complete response, as necessary.
  • Follows strict guidelines to ensure all work meets corporate standards for accuracy, timeliness, quality and compliance with federal, state, BCBSA and accreditation regulations.
  • Organizes and keeps readily accessible all reference documents, policies and procedures needed to accomplish this.
  • Facilitates the member's or provider's understanding of the preauthorization process and of the information necessary to effectively process a preauthorization, as needed.
  • Utilizes knowledge and understanding to research difficult or complex documentation and requests related to UM processes and requirements, and CM and DM programs from members, providers, employer groups, agents, member representatives and internal customers.
  • Draft written notifications in compliance with all regulatory and quality entities to members and providers to request medical records and additional information, and communicate UM determinations, cancellations, and other necessary communications.
  • Tracks and monitors individual timeliness of UM reviews to ensure all Regulatory and Quality timeliness requirements are met.
  • Acts as a role model for other specialists; demonstrates and promotes an ethical work environment with internal and external contacts.
  • Assists with coaching, mentoring, and training, as directed by Supervisor.
  • Helps to answer questions for all levels of staff. Performs detailed research and problem-solving using sound decision-making skills after thoroughly researching the facts.
  • Participates in quality activities, task forces or work groups, or other training and/or process improvement teams.
  • Assumes a leadership role in identifying areas for improving the systems necessary to perform work and make appropriate recommendations.
  • May assist with systems testing if applicable.

$19-22 DOE


Location: Remote - Candidates MUST be located in one of the four states in which the client operates: Oregon, Washington, Idaho or Utah.


Equal Opportunity Employer/Veterans/Disabled


To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy


The Company will consider qualified applicants with arrest and conviction records

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