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Intake Coordinator Job



Job Number: 76495924644

Location: Pittsburgh, PA

Date Posted: 3-24-2017

 

Wexford Health Sources, the nation's leading innovative correctional health care company, provides clients with experienced management and technologically advanced services, combined with programs that control costs while ensuring quality.  For nearly two decades, Wexford Health has consistently delivered proven staffing expertise and a full range of medical, behavioral health, pharmacy, utilization management, provider contracting, claims processing, and quality management services.

At Wexford Health our philosophy is that health care should not be considered a luxury for anyone.  We simply care for those in need and the corrections environment is our venue.

Wexford Health has an exceptional opportunity for a full-time Intake Coordinator to join our team of healthcare professionals at our Corporate Office in Green Tree, PA.

We’re proud to offer a competitive benefits package including:

  • Annual review with performance increase
  • Generous paid-time off program that combines vacation and sick leave
  • Paid holidays
  • Comprehensive health insurance through Blue Cross Blue Shield
  • Dental and Vision insurance
  • 401(k) retirement saving plans
  • Company-paid short-term disability
  • Healthcare and dependent care spending account

POSITION SUMMARY

The Intake Coordinator coordinates daily flow of information between sites and Utilization Management Department.  Maintains and updates appropriate data input into the system assisting with data entry and outcome.  Communicates with site to encourage compliance with Wexford's policy and procedures as they relate to Utilization Management.

DUTIES/RESPONSIBILITIES

Daily:

  1. Fax's Launch Reports to all sites, check confirmations and file.
  2. Assure receipt of the Daily Activity Report from each site. Notifies Manager of UM of site non-compliance.
  3. Enter all inpatient admission and discharge information into database
  4. Confirm outpatient surgery information has already been approved; enter date of service into database and appropriate log.
  5. Review Daily Activity Report (DAR) for unusual occurrences (Emergency trips/x-rays) and ensure receipt of appropriate referral request forms from the site. Enters actual dates of services in computer.
  6. Enter all ER, ER radiology, inpatient, and urgent office requests into the database.
  7. Receipt of all referral requests via fax, and route to the appropriate nurse for review.
  8. Review all no auth claims, call sites for Retro-referrals.  Process referral requests.
  9. Enters all retrospective referrals and notates reason for non-compliance for reporting purposes.
  10. Researches and completes claim issues sheets.
  11. Answer UM phones.
  12. Checks EPHR daily for referrals and routes all messages to UM Manager

Weekly:

  1. Monitor DAR Report Compliance.
  2. Monitor Retrospective/NoAuth Report

The duties and responsibilities outlined herein are for payroll purposes only; employees may be assigned other duties as required.

ENVIRONMENTAL CONDITIONS

Standard office environment.


 

EDUCATION: High School Graduate or equivalent, specialized training in health care claims management.

PREFERRED EXPERIENCE:

  • Minimum five (5) years’ experience processing claims in a physician office
  • Knowledge of ICD-9
  • CPT coding experience

EOE/M/F/D/V


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