Clinical Services – Intake Coordinator

Location: Pittsburgh

Job Type: Contract

Job Description: This job captures all inbound requests for utilization review from providers and pharmacies. The incumbent assesses the request, conducts all necessary research such as verifying benefit coverage for the patient, and then creates the case (data entry) in the utilization management system for clinical review. Ensures all accurate information is entered at the onset of the process to ensure adherence to all regulatory compliance requirements and service level agreements. The requests may come via fax or phone, and at times may require follow-up calls with physicians or pharmacists. The requests may come via fax or phone, and at times may require follow-up calls with physicians or pharmacists.

Job Details: • 100% remote – however manager prefers candidates local to Pennsylvania or West Virginia • Training period is at least two-six weeks. No time off can be taken during training. • Work schedule during training will be 8:30am-5:00pm, subject to change • Following the completion of training, the work shift will change to 10:30am-7:00pm, though this work schedule may change • Must be flexible on work schedule • May be required to work on weekends or holidays as business needs • 6 month contract only, NOT contract to hire, might have an extension • U.S. Citizens ONLY

***Candidates who successfully complete training (approx.. 6 weeks after start date) will receive a bonus of $250. ***Candidates who successfully complete 6 months of work on assignment will receive a retention bonus of $250.

Required Skills: • HS Diploma or GED Required • This is a call center, you MUST be willing to take phone calls for the duration of your shifts. • Customer Service Skills required • Call center experience • Must be comfortable in teleworking and have a workspace free from distractions • Must have prior experience with a high call volume • Must be comfortable answering phone calls • Microsoft office experience (Excel, Outlook, Word) • Must have problem solving skills • Must be adaptive • Must be good at following instructions • Must be willing to do phone work as it is the basis of this role • Excellent communication both verbal and written • Attentive to details • Insurance experience preferred • Medical background preferred • Medical Coding experience to recognize/read the category codes, not to actually code the diagnoses, is preferred • Must be a quick learner and has the ability to work independently, pay attention to detail, and have the ability to produce high quality work.

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