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Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job monitors the day to day functions of the Intake team. This includes running call statistics for the individual intake coordinators as well as the team. Monitors incoming calls to ensure customer service and quality measures are met. Assembles the monthly audit packets for the department Supervisors. Performs the duties of a Senior Intake Coordinator including: assessing the request, conducting all necessary research such as verifying benefit coverage for the patient, and then creating the case (data entry) in Highmark's utilization management system for clinical review.

ESSENTIAL RESPONSIBILITIES

• Review cases for errors, listen to calls for quality, complete scorecards that captures data to submit to supervisors

• Oversee the training needs for the department to include evaluation of the need for training, creation of training for process and system changes, and new hire training and mentoring

• Triage, build cases, answer calls from providers when needed, especially during high volume times.As the subject matter experts, handles escalated calls from providers.

• Ensure that front line resource center (SharePoint) is up to date.Develop tip sheets and provides information to the team.Act as the go- to person for questions from the team on a day to day basis (face to face, phone, instant messenger, email).

• Participate in all special projects.

• Other duties as assigned.

EDUCATION

Required

• High School Diploma/GED

Substitutions

• None

Preferred

• None

EXPERIENCE

Required

• 3 - 5 years of Customer Service experience

• 1 - 3 years of experience working in the Healthcare Industry

Preferred

• 1 - 3 years of experience working in the Health Insurance Industry

LICENSES AND CERTIFICATION

Required

• None

Preferred

• None

SKILLS

• Oral & Written Communication Skills

• Telephone Skills

• Problem-Solving

• Healthcare Industry

• Health Insurance

• Mentoring

• Training

Language (Other than English)

None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Occasionally

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$17.20

Pay Range Maximum:

$27.82

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J241614