Job: Non Clinical Administrative Intake

Provides initial screening of service request, from Providers and/or members. Assists with non-clinical functions of department, including but not limited to: receiving faxes, answering phones, data entry of service requests using structured guideline

ESSENTIAL, DUTIES AND RESPONSIBILITIES: Include the following. Other duties may be assigned.

Performance of “review of service requests” for completeness of information.

Collection of demographic information and transfer of non-clinical data per departmental requirements.

Collects and data –enters clinical data supplied by patient or provider into the company’s electronic medical record.

Conducts limited activities related to prior approved services that do not require evaluation or interpretation of clinical information.

Maintains telephone queue performance standards and assist callers appropriately.

Maintains process for faxed requests sorting and distribution.

Indentifies member eligibility and benefit plan for processing request for service.

Works in compliance with applicable laws and URAC Standards.

Communicate outcomes of request per mail or phone as directed per policies guideline.

Protects and secures all identifiable personal health information according to HIPPA requirements.

Maintains high degree of confidentiality on all patient information.

Identifies and reports Provider and Member issues to management staff.

Collects performance data as required per productivity reporting guidelines.

Understands and applies designated scripts or protocols used in pre-review screening.

Other duties as assigned

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Excellent organizational skills.

Computer literate

Good interpersonal and communication skills

Working knowledge of medical terminology

Ability to follow instructions – both oral and written.

EDUCATION and/or EXPERIENCE

High school graduate

At least 6 months of additional education or training or

1 year minimum managed care or physician’s office experience

Must be certified Medical Assistant