Intake Specialist

We’re hiring an Intake Specialist to join the Commercial UM Operations Team! Based on established guidelines, the Intake Specialist processes a variety of internal and external member/provider requests and transactions,. Receives, screens, and enters data in preparation for review. Complies with timeliness standards and reduces unpaid claims and rework by accurately processing requests. May also assist on special projects as needed.What You’ll DoProcess a variety of requests, inquiries and transactions via phone, email, fax, and mailReview requests to ensure accuracySupport internal & external customers via phone or emailDocument all pertinent information related to the call/inquiry, attach supporting information as applicable and if unable to resolve route to appropriate area for follow up as applicableGather and analyze data to provide feedback to Team Leads on employee development needs and/or specific providers requiring education on prior approval or pre-certification processScreen inquiries to determine if authorization is requiredVerify member benefits and eligibility and/or provider setup.Maintain and update Service Requests and research incorrect or missing information.Triage and assign all incoming inquiries in a timely, efficient manner throughout the day to appropriate staffPerform Peer Audits monthly as requiredProvide clinical review outcome notification to members and providers (verbal and written)What You BringHigh school diploma or GED3+ years of experience in related field.Bonus Points (Preferred qualifications)Prior telephone-based customer service experience strongly preferred.Familiarity with and understanding of medical terminology is a plus.What You’ll GetThe opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the communityWork-life balance, flexibility, and the autonomy to do great workMedical, dental, and vision coverage along with numerous health and wellness programsParental leave and support plus adoption and surrogacy assistanceCareer development programs and tuition reimbursement for continued education401k match including an annual company contributionLearn moreWhere You’ll WorkOur Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused.In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter.Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.Salary RangeAt Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.Based on annual corporate goal achievement and individual performance.$41,600.00 - $66,561.00Skills_____________________________________________________________________JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: View email address on click.appcast.io. #J-18808-Ljbffr