Intake Specialist-3

Job Description

Based on established guidelines, the Intake Specialist processes a variety of internal and external member/provider requests and transactions,. Receives, screens, and enters data in preparation for review. Complies with timeliness standards and reduces unpaid claims and rework by accurately processing requests. May also assist on special projects as needed.

This role is designated as Remote Flex – no standard weekly in-person onsite expectations. There may be opportunities to meet on campus up to 2 times per year.

What You’ll Do

• Process a variety of requests, inquiries and transactions via phone, email, fax, and mail

• Review requests to ensure accuracy

• Support internal & external customers via phone or email

• Document all pertinent information related to the call/inquiry, attach supporting information as applicable and if unable to resolve route to appropriate area for follow up as applicable

• Gather and analyze data to provide feedback to Team Leads on employee development needs and/or specific providers requiring education on prior approval or pre-certification process

• Screen inquiries to determine if authorization is required

• Verify member benefits and eligibility and/or provider setup

• Maintain and update Service Requests and research incorrect or missing information

• Triage and assign all incoming inquiries in a timely, efficient manner throughout the day to appropriate staff

• Provide clinical review outcome notification to members and providers (verbal and written)

What You Bring

• High school diploma or GED

• 3+ years of experience in related field

Bonus Points

• Prior call center experience, strongly preferred

• Excellent verbal and written communication skills

WhatYou’llGet

• The opportunity to work at thecutting edgeof health care delivery with a teamthat’sdeeply invested in the community 

• Work-life balance, flexibility, and the autonomy to dogreat work 

• Medical, dental, and vision coverage along withnumeroushealth and wellness programs 

• Parental leave and support plus adoption and surrogacyassistance 

• Career development programs and tuition reimbursement for continued education 

• 401k match including an annual company contribution 

• Learn more 

WhereYou’llWork

Our Hybrid Flex approach is builton presencewith a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplacethat’sflexible, connected, and future focused.

In a Hybrid-Flex role,you’llwork in the office at least two days a week for collaboration and connection. In a Remote Flex role,you’llwork virtually, with a few in-office visits each year formeaningfulmoments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in anystateslistedonthis job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$41,600.00 - $66,561.00

Skills

JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: [email protected].

Originally posted on Himalayas