Imagine360 is currently seeking a Medical Intake Specialist, Utilization Management to join the team! The role of the Medical Intake Specialist is responsible for starting the notification process by following Medical Management Policy and Procedures by utilization of electronic hardware and/or software. The Medical Intake Specialist is also responsible to provide no clinical support duties as indicated for the HealthWatch department.
Position Location: 100% Remote
Responsibilities include but are not limited to:
- Perform all tasks in accordance with Department of Labor, HIPAA, ERISA and HealthWatch Policy and Procedure
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Utilize computer software/hardware and other office equipment to consistently and accurately enter data to complete the notification process in compliance with Medical Management Notification Policy and Procedures- Appropriately prioritize calls received in the telephonic intake queue
- Refers to licensed clinical staff for oversight if interpretation of clinical information is needed.
- Accurately identify and provide HIPAA compliant information to callers regarding medical services requiring notification per Medical Management Notification Policy and Procedure
- Complete data entry of notification and obtain clinical information and/or results of diagnostic testing as indicated per the Medical Management Notification Policy and Procedure
- Contact provider/facility to confirm the date of service, as indicated per HealthWatch Notification Policy & Procedure, with appropriate documentation in case tracking software in compliance with HealthWatch Policy and Procedures
- Consistently complete appropriate documentation in indicated software including but not limited to CaseTrakker, GBAS and Docushare per Medical Management Policy and Procedures
- Consistently demonstrate engagement in professional conversation in all internal and external communication (verbal and/or electronic)
- Attend scheduled and periodic meetings trainings, and other job specific events as required either by teleconference or onsite
- Participation in Quality Management program per policy and procedures
- Report preparation as assigned
- Consistently utilizes script communication.
Required Experience / Education:
- High School diploma or equivalent
What can Imagine360 offer you?
- Multiple Health Plan Options, including a 100% Employer Paid Benefit Options
- 100% Company paid employee premiums for Dental, Vision, STA, & LTD, plus Life Insurance
- Parental Leave Policy
- 20 days PTO to start / 10 Paid Holidays
- Tuition reimbursement
- 401k Company contribution
- Professional development initiatives / continuous learning opportunities
- Opportunities to participate in and support the company's diversity and inclusion initiatives
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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.
Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**
