Utilization Intake Review Coordinator

Job Description

Job Description

Description:

Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Intake Coordinator, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.

Under the supervision of the Utilization Review Process Manager and Lead Utilization Review Intake Coordinator, the Utilization Review Intake Coordinator is responsible for managing the initial intake and data entry of clinical information required for the utilization review processes. This includes verifying patient information, preparing and submitting authorization requests to the nursing staff or external UR vendor AHH. The intake coordinator plays a key role in ensuring timely reviews and preventing delays in treatment.

Responsibilities

• Supports the daily operations of the Utilization Review department by assisting the Lead Utilization Review Intake Coordinator with various requested tasks.
• Data entry of clinical and intake information to the appropriate platform, directed to the appropriate vendor.
• Maintains a current knowledge base of UR processes and timelines.
• Uses good listening skills, conducts outreach calls, collects data according to script, tools, and protocols meeting both productivity and performance expectations as identified by the lead and manager. Conducts all calls in a courteous and customer service friendly manner. Refers to appropriate staff when indicated by workflow.
• Processes incoming and outgoing correspondence/faxes as assigned in accordance with required standards and within respective timeliness guidelines. Referring to the appropriate clinical team members for review as defined by workflow.
• Clerical responsibilities such as processing urgent scanning, and document retrieval routed to UR.
• Demonstrates a professional and courteous manner when communicating with others with the ability to state clearly and accurately the agreed upon resolution.
• Adhere to, Standard Operating Procedures and maintains current knowledge of member benefits, rights and responsibilities.
• Performs other related duties and projects as assigned within the assigned timeframes.
• Interprets Plan language and applies to intake tasks.
• Adheres to company policies and procedures.

• High school diploma or equivalent required.
• Minimum of 1-2 years of experience in healthcare field.
• Fluent computer skills including MS Office (Word, Excel, and Outlook) and Internet applications.
• Strong reading comprehension
• Self-motivated, self-directed, operates without constant guidance.
• Excellent communication and problem-solving abilities.

Benefits

After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:

• Fantastic medical, dental, and vision insurance*
• Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
• Company provided Basic Life and AD&D
• Company paid Short-Term and Long-Term Disability**
• Flexible Spending Accounts*
• 401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)
• 10+ paid holidays
• Generous paid vacation and sick time
• Annual Volunteer Paid Day
• Annual Tuition Reimbursement
• Annual Health and Wellness Reimbursement
• Lots of fun company events

Benefit Waiting Period Notes:

*60 day waiting period

**90 day waiting period

Who We Are:

As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our four companies: EBPA, Blue Benefit Administrators of Massachusetts, CBA Blue and Great Bay Administrators. With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit

Cobalt Benefits Group is an Equal Employment Opportunity employer.

Cobalt Benefits Group participates in E-Verify to confirm the employment eligibility of all new hires.