Intake Coordinator Care Management

Job Description: The Utilization Management department oversees delegated services for plans under managed care contracts. The Intake Coordinator in Utilization Management provides superior customer service by responding to inquiries related to pre-authorizations from members, providers, facilities, vendors, and internal departments. This role involves speaking with referral sources, collecting and entering information into the system, processing authorizations, and verifying insurance to ensure patients receive appropriate care from the correct departments or referral sources. The Intake Coordinator also uses data and established processes to identify members who may benefit from Care Management services and takes appropriate action to initiate referrals. Additionally, this role serves as a trainer and mentor to new team members, supporting onboarding and providing ongoing guidance. This position is hybrid. This person will be required to be in office while in training, then remote with expectation that they come into the office 4-5 times a month. Essential Functions Provides telephone customer service by answering and returning calls promptly and courteously. Triages calls as appropriate and responds to requests accurately and in a timely manner. Complies with all information, privacy and confidentiality policies and regulations. Communicates with referral sources to gather and input intake information into the computer system, completing the intake process. Interfaces with third-party payers to determine insurance benefits or self-pay status at the time of intake, including reviewing EOBs, EOCs, and authorization lists. Establishes and maintains effective working relationships with both internal and external stakeholders. Assists in training new employees in account preparation and review functions, under the direction of a Lead or Level II team member. Expedites urgent cases, including those related to discharge planning, by collaborating with the appropriate discharge team members to gather required information. Obtains and verifies insurance eligibility and benefits using various phone and online resources. Translates narrative diagnoses from physicians or patients into appropriate ICD-10 and CPT codes. Adheres to regulated turnaround times for all service requests, including expedited handling of high priority cases. Organizes daily activities to ensure the departmental operations meet established standards. Escalates issues and concerns to Level II, Lead, or department leadership as applicable for prompt resolutions. Skills Customer Service Computer Literacy Computer Systems/technology capable Telephone Communications Attention to Detail Data entry/typing Problem Solving Minimum Qualifications Demonstrated customer service experience in healthcare setting. Knowledge of medical terminology or medical background. Preferred Qualifications Bilingual in Spanish and English, with the ability to communicate effectively across both languages in a healthcare setting. One (1) year of work experience with Medicare, Medicaid, and commercial insurance plans, including preauthorization and utilization management. Proficient in CPT, HCPCS, and ICD-10 coding. Physical Requirements Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs. Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc. For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles. Location: Nevada Central Office Work City: Las Vegas Work State: Nevada Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $19.31 - $26.22 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here. Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process. All positions subject to close without notice. Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment. To find out more about us, head to our career site here. Sign up for job alerts! Click ‘sign in’ at the top right corner, create a candidate account, and when we have opportunities that meet your interests, you will receive an email with the job details. Intermountain Health strives to make the application process accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact View phone number on click.appcast.io or email View email address on click.appcast.io. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Introduce yourself to our Talent Acquisition team and we will get in touch if there is a role that seems like a good match. Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor. All positions subject to close without notice. Thanks for your interest in continuing your career with our team!