We are currently seeking an Intake Representative.

In this role, you will have a variety of objectives which include processing requests after physician review, Medicaid verification, screening cases and etc. 

Please contact Shane Hector, Recruiter, with your resume at shector@nri-staffing.com.

If you are excited about this role, please apply today. If you are unsure that you qualify, please apply anyway and our experienced recruiters will evaluate your application. 

We are always looking for new talent of diverse backgrounds for our clients.

Duties and Responsibilities

• Process requests after physician review, evaluating language and working with physician reviewers, clinical reviewers, or managers to ensure language and determination information is complete before sending letters to providers.
• Obtain clinical information from the client systems when indicated or contact provider to obtain information required for review.
• Determine based on training when a scripted review is indicated based on contract requirements 
• Provide notification of completed review and additional information needed, when applicable
• Convey case information and other notifications via inbound and outbound calls. 
• Enter case information from original source documentation or validate information entered by providers in the portal
• Medicaid verification (provider, beneficiary and or member. Validate the request submitted via the Health Provider Portal for accuracy and completeness.
• Assist providers to submit documentation of requests for utilization review, and other medical management services.
• Enter documentation of requests for utilization review, and other medical management services (collect/enter information into the system that is limited to non-clinical data or is structured clinical data).
• Screen cases for required medical information based on type of request, determining if information is sufficient for clinical review
• Respond to inbound telephone requests with clear documentation in the care management system of calls.
• Performs all other duties related to the position

Qualifications

• 2 years of relate work experience or customer service experience
• 1 year of work experience in healthcare

Education

• Associate Degree in a healthcare related field preferred; would consider other disciplines with healthcare related experience
• Post-secondary education or certification in a related field (preferred)