INTAKE COORDINATOR

JOB DESCRIPTION    POSITION TITLE: Intake Coordinator  REPORTS TO:  Health Services Executive Director   STATUS:  Hourly  LOCATION:  Raleigh North Carolina, Macon Georgia or Austin Texas  JOB SUMMARY: The Intake Coordinator position plays in important role in the success of Arcadian Management Services and as such is responsible for assisting in the implementation and ongoing management of the utilization management program.  This position is multifaceted and requires a diverse set of organizational skills.  The Intake Coordinator is positioned strategically to work closely with the physician office staff, the UM Nurse/ Case Manager, health plan representatives, service center staff and on occasion the patients.  The Intake Coordinator is key to assisting the UM Nurse/Case Manager in coordinating timely and cost effective health care for all members.   QUALIFICATIONS: § Education:  § Associate degree or equivalent from an accredited college § Experience:  § Minimum of 2 years office experience in a medically related field (e.g., physician office, home health department, physical therapy office) § Experience with computer and software programs (e.g.; Microsoft word, excel) and the Internet§ Experienced in data entry, 10 key data entry§ Type 50+ WPM § Skills:§ Excellent administrative, organizational, and follow-up skills§ Proficient in medical terminology§ Familiarity with ICD9-CM, RBRVS, CPT and DRG coding§ Familiarity with claims processing§ Effective communication style (written and verbal) with proven ability to positively influence behavior and arrive at a “win-win” resolution§ Excellent telephone skills§ Strong computer and data entry skills, ability to type at least 50 wpm§ Demonstrated skills in problem resolution§ Independent thinker, logical§ Ability to implement policies and procedures § Job Duties and Responsibilities: § Assist the licensed nursing staff with the non-clinical tasks associated the performance of pre-authorization, concurrent, and retrospective review for all inpatient and outpatient services, as outlined in the utilization management program; for example:§ Intake authorization and referral requests § Assign procedure or diagnostic codes as necessary§ Enter at minimum into computer:§ 65 authorization requests/day with 98% accuracy and take up to 20 telephone call/day, or§ 75 authorization requests/day with 95% accuracy and take up to 20 telephone call/day, or§  90 authorization requests/day with 98% accuracy with not more than 5 telephone calls/day, or§ 100 authorization requests/day with 95% accuracy with not more than 5 telephone calls/day, or§ Take at least 50 calls/day and enter up to 5 Urgent or Emergent authorization requests with 99% accuracy, provide NODMAR letters, and keep Pending Queues up to date § Follow up with UM Nurse/Case Manager on outstanding requests§ Communicate with providers on status of outstanding requests§ Verify member eligibility via computer and/or appropriate website§ Determine member benefit coverage and refer to UM Nurse/Case Manager when appropriate§ Perform duties in such a way as to insure that Arcadian meets NCQA guidelines and health plan delegation requirements for utilization management§ Provide administrative support to the UM Nurse/Case Manager in the development, implementation and ongoing management of the following:§ Eligibility process§ Denial and appeal process/letters§ Preferred provider list§ Filing§ Data entry of authorizations§ Liaison with Service Center regarding provider and member reimbursement/claim questions§ Perform administrative duties as necessary, included but not limited to, answering the telephone, filing, typing, assembling, and distributing manuals, letters, lists, minutes, etc…§ Assist UM Nurse/Case Manager with education and training of the provider office staff Physical Requirements of the Position:§ Sitting:  The essential functions of this job are performed while seated at a desk or work station for at least 85% of scheduled work hours§ Standing and walking: The essential functions of this job require the ability to move from one location to another either by walking or driving.§ Hearing:  Must be able to receive and send detailed information through oral communication and clearly understand people speaking in her/his presence and over the telephone§ Speaking:  The essential functions of this position require speaking and communicating English in a clearly understood voice at all rimes during scheduled work hours§ Fingering and repetitive motions:  Functions of this position require a significant amount of movements of the wrists, hand, fingers in the use of office equipment such as phones and computer keyboards§ Vision:  The essential functions of this position require the ability to clearly see detailed information via written manuscript and or computer§ Lifting:  A function of this position requires the ability to lift at least twenty-five pounds on an occasional basis. Salary:  Starting salary is based on qualifications and experience.   Approved:   Nurse Manager Date   Employee  Date