Behavioral Health - Intake Specialist 150-1005

CommunityCare • Tulsa, OK

5d

About The Position

The Behavioral Health Intake Specialist provides customer service support for behavioral health benefits, directs members to appropriate in-network services, processes prior authorizations according to CMS and state regulations, sends provider faxes and member letters, and resolves behavioral health-related situations arising from calls. The role provides telephone support for behavioral health needs across all lines of business from 8:00 a.m. to 5:00 p.m., except during lunch and breaks. Work may involve assisting members who are disgruntled or upset. Other duties may be assigned as required.

Requirements

• Basic punctuation and grammar skills.
• Ability to multitask and manage time efficiently.
• Proficiency in Microsoft applications.
• Ability to work independently and apply good judgment.
• Ability to maintain and preserve highly confidential information.
• Strong oral communication skills.
• Successful completion of a Health Care Sanctions background check.
• High school diploma or equivalent.

Nice To Haves

• Customer service, office management, and/or healthcare experience is preferred but not required.

Responsibilities

• Provide telephone support for behavioral health needs across all lines of business from 8:00 a.m. to 5:00 p.m., except during lunch and breaks.
• Resolve calls involving referrals, authorizations, member eligibility, lines of business, and member or provider network affiliations.
• Determine whether calls are clinical and require transfer to clinical staff.
• Inform members, facility personnel, physicians, and other health care professionals about utilization requirements and procedures.
• Make initial referrals to behavioral health services when evaluation or interpretation of clinical information is not required.
• Complete electronic certification and progress-note documentation as needed.
• Assist with specialized administrative tasks, including claims corrections and follow-up on provider or member questions about claims payments.
• Generate provider faxes and member letters.
• Perform other duties as required.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED