Intake Coordinator

Who We Are

Point
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Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point
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Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are.

We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

Point
32

Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point
32

Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are.

We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point
32

Health.

Respond to provider queries, enter administrative authorization data into the computer system, and maintain proper documentation and files to support care of members, customer service, and other departmental functions. Enters all referral/data information into the computer system, maintains proper documentation and facilitates coordination of services. The position will be directly associated with incoming referrals and authorizations for the utilization component of medical management.

Key Responsibilities/Duties – what you will be doing:

• Receives incoming authorization requests from providers, via fax, portal & telephone to create an event or transaction by lines of business for the UM teams to review and decision requests
• Contacts provider offices for further details on clinical information.
• Research member eligibility and primary care selection to complete entry of the event.
• Documents and maintains all telephone calls and enters a note on each call/inquiry made. Documents all admissions, and referrals. Maintains flow and storage of information such as messages, forms, and logs.
• Works with providers and other members to solve complex and urgent issues. Ensures that appropriate person/department from across the organization is appropriately involved with applicable issues.
• Data entry of Authorization Requests for all Inpatient stays – Outpatient requests as needed, into information system.
• Represents Medical Management at applicable activities including system user groups and other health data system organizations.
• Attends organization-wide meetings and department staff meetings.
• Maintains professional growth and development through self-directed learning activities and involvement in professional, civic and community organizations.
• Other duties as assigned by the Intake and Outreach Coordination leadership.

Certificatio…