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As an Intake Specialist, you will be a key part of the initial review process for medical and surgical service requests. You’ll ensure that provider submissions are complete, accurate, and include all required clinical information. You’ll also serve as a point of contact with providers, helping to gather missing data, and forwarding submissions to the clinical review team. Clear and timely communication is essential.

Responsibilities

• Review incoming requests submitted via the Provider Portal for medical/surgical services. Validate that submissions are accurate and complete.
• Screen requests to determine whether the clinical information included is sufficient for further review; if not, follow up to obtain missing information from providers or client systems.
• Enter or verify case information in the management system, ensuring data integrity and accuracy. 
• After physician or clinical review, process determinations (approvals, decertifications, denials) and prepare communications/letters to providers. Ensure required contract or regulatory notification procedures are followed. 
• Respond to inbound phone calls and system notifications from providers or other stakeholders, documenting interactions clearly in the care management system. 
• Notify providers of completed reviews and any additional information needed. 
• Support orientation and training of other intake / non clinical staff as needed. 
• Assist in quality assurance / internal reviews of intake workflows, templates, and provider outreach when required. 

Qualifications

• Minimum of 2 years of work experience in a related field or customer service role.
• High school diploma or equivalent; combination of education and/or relevant work experience may be substituted. Some post secondary education or certification in a healthcare related field, preferred. 
• At least 1 year of experience in healthcare or a healthcare adjacent setting.
• Proficiency in medical terminology.
• Strong skills with computer systems (data entry, case / care management systems), and with standard office software (e.g. Microsoft Office). 
• Experience as a medical assistant, nursing assistant, or in another direct patient care or provider support role.
• Attention to detail — able to review documentation carefully and identify omissions or inconsistencies.
• Strong communication (verbal and written) — able to interact with providers, other staff, and stakeholders clearly and empathetically.
• Organizational skills — managing multiple intake requests simultaneously, tracking outstanding information, and following up as needed.
• Problem solving / investigative mindset — able to track down missing information, interpret clinical documentation, clarify with providers.
• Reliability and ability to meet deadlines.

For immediate consideration, send your resume to mmercer@nri-staffing.com