Intake Coordinator at Tufts Health Plan in Watertown, Massachusetts

Job Description:

We enjoy the important work we do every day on behalf of our members.

Job Summary

Job Description

Assist in coordination of workflow for the Behavioral Health/Medical Clinical Management Team. Work with all members of the Clinical Operations team (which includes Utilization Review, Case Management, Disease Management, Quality Management) helping to support these programs and the department. 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 behavioral health/medical.

The Intake Coordinator promotes the mission and values of Intake/Outreach Department, Tufts Health Plans (THP) by demonstrating an empathetic and professional demeanor always. Available for all Intake/Outreach behavioral health/medical special projects and needs.

Job Description

PRINCIPAL DUTIES AND RESPONSIBILITIES

ESSENTIAL FUNCTIONS:

• Contacts provider offices for further details on referrals, if necessary. Researches member eligibility and primary care selection to complete entry of referral.


• Documents all admissions and referrals. Maintain flow and storage of information such as messages, forms, and logs.


• Assist team personnel with establishing and maintaining efficient communication processes with providers.


• Maintain the flow and storage of information within Intake/Outreach Coordination ensuring it is placed in the appropriate place/registry.


• Maintain and update daily inpatient census.


• Maintain workflow of clearing, sorting and distribution of incoming faxes and authorization requests.


• Data entry of Hospital Admissions, Durable Medical Equipment, Office Visits, Medical Injectables, Referrals, Outpatient Procedures, and various Inpatient and Outpatient requests.


• Data entry of Authorization Requests for Acute Treatment Services -- Substance Abuse into information system and send out authorization letter to facility. Identify any outliers and triage to care manager for review.


• Data entry of ATS-SA discharge reviews and change authorization, as indicated.


• Conduct outreach calls to providers as follow-up to 14-day post hospitalization medication continuing care visits


• Prioritize work duties in order to maintain customer satisfaction through prompt and efficientservice.

Requirements

Job Requirements

Education:

• High School degree required or 2-3 years of equivalent experience;


• Associates degree strongly preferred.

Skills/Experience:

• Minimum of 1-year experience working within a managed care,behavioral health/medical or customer service environment.


• Medical terminology and Medicaid experience a plus.


• Knowledge and experience in database software. Intermediate knowledge of Microsoft Office Suite or other similar software applications.


• Exceptional internal and external customer service skills. Ability to multitask.

What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!

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