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Intake Representative – Comagine Health

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Typical Job Duties and Responsibilities:

  • Validate the request submitted via the Comagine Health Provider Portal for accuracy and completeness.
  • Screen requests for required clinical information based on type of request, determining if information is sufficient for clinical review.
  • Obtain clinical information from the client systems when indicated or contact provider to obtain information required for review.
  • Process requests after physician review, evaluating language and working with physician reviewers, clinical reviewers, or managers to ensure language and determination information is complete before sending letters to providers.
  • Respond to inbound telephone requests with clear documentation in the care management system.
  • Enter case information from original source documentation or validate information entered by providers in the portal.
  • Provide notification of completed review and additional information needed, when applicable.
  • As requested, contribute to orientation and training of other non-clinical employees.
  • As requested, create templates for complex reviews, perform internal quality reviews, and/or participate in provider outreach activities.
  • May perform scripted non-clinical reviews and refer reviews requiring further action to clinical review staff
  • After physician review, notify providers of decertification or potential denial of services by phone or in writing as required by contract.

 

Competencies:

  • Intermediate understanding of medical terminology.
  • Intermediate MS Office Suite proficiency.
  • Demonstrated proficiency with medical terminology.
  • Participates in orientation and training of other Intake staff.

 

Required Qualifications:

  • High school diploma or equivalent (equivalent combination of education and/or work experience in related field may be substituted).
  • 2 years of related work experience or customer service experience.
  • 1 year of work experience in healthcare.

 

Candidates should ideally reside within Pacific Time Zone or Mountain Time Zone.

 

Desired Qualifications:

  • 2 years of work experience in healthcare; nursing assistant or medical assistant experience.
  • Post-secondary education or certification in a health care related field.

 

Salary Range: $17.50 – $24.00 per hour