Precert Intake Coordinator

Description:

The Intake Coordinator position is responsible for providing support services to clinical staff in accordance with OneVeracity policies and procedures. The position responsibilities include the coordinating of incoming calls and setting up case files in the electronic medical record system for clinical staff. Additional responsibilities include locating specialists and resources for members to meet their health needs, communicating with provider offices, sending faxes/emails, and managing incoming communications for the Precertification, Case Management and Care Navigator programs.

• Receive and coordinate all incoming calls for distribution to proper department and/or individual.
• Collect clinical information and set up cases for medical necessity review for precertification services.
• Collaboration and communication with providers regrading the status of their precertification request.
• Assist in distribution and assignment of internal referrals.
• Send determination letters to appropriate parties.
• Coordinate all incoming faxes for distribution to proper department and/or individual.
• Verify network status of providers and facilities.
• Assist with locating available resources and specialists for members.
• Coordinates access to providers, community resources, and health benefits as necessary.
• Accurately and clearly documents case activities included but not limited to verbal communication with providers/facilities, outgoing communication including faxes & emails, incoming communication, referral of cases to internal and external vendors/programs, and identification of resources.
• Engages clinical staff or other designated supervisor for consultations when appropriate.
• Coordinates appeals when requested by clinical staff.
• Completes tasks and special projects as assigned.
• Assist with departmental reporting as required.
• Participates in regular company, departmental and committee meetings.
• Participates in providing feedback and input into program services, procedures, and resource needs.
• Maintains confidentiality in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Requirements:

• High School Diploma (required)
• Associate in Arts (AA)/Associate in Science (AS) degree or higher (preferred)
• Experience working in medical services background with knowledge of medical terminology
• Experience working in a managed care setting preferred
• Strong Problem-solving skills are essential
• Excellent typing, computer and documentation skills
• Knowledge of Microsoft Office products (Outlook, Word, Excel)
• Ability to coordinate and communicate with a multidisciplinary team (internal and external)
• Strong customer service skills
• Ability to multi-task

About OneVeracity

OneVeracity partners with brokers to help self-funded employers reduce medical and pharmacy costs without compromising care. It delivers Health Plan Solutions, VeracityRx, Care Solutions, and Onsite Health Centers in one integrated model that gives employers a clearer, more coordinated way to manage healthcare spend. The approach is grounded in three guiding principles: enhance care, reduce costs, and make it easy. Founded in 2019 and headquartered in Kennesaw, Georgia, OneVeracity is a privately held company that serves self-funded employers across industries including manufacturing, government, and professional services. Learn more at www.OneVeracity.com.