Behavioral Health - Intake Specialist 150-1005

Community Care • 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 in accordance with CMS and State regulations, sends provider faxes and member letters, and resolves behavioral health situations arising from calls. The role provides telephone support for behavioral health needs across all lines of business from 8 AM to 5 PM, except during lunch and breaks. It handles calls about referrals, authorizations, member eligibility, lines of business, and network affiliations, and determines when a call is clinical and should be transferred to clinical staff. The specialist informs callers about utilization requirements and procedures, makes initial referrals that do not require clinical interpretation, documents activities, and may assist with claims-related follow-up and other administrative work. The position may involve interactions with disgruntled or upset members.

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 AM to 5 PM, except during lunch and breaks.
• Resolve calls concerning referrals, authorizations, member eligibility, lines of business, and network affiliations for members and providers.
• Determine whether calls are clinical and require transfer to a clinical staff person.
• Inform members, facility personnel, physicians, and other health care professionals about utilization requirements and procedures.
• Make initial referrals to behavioral health services when no evaluation or interpretation of clinical information is required.
• Complete electronic certification and progress-note documentation of activities as needed.
• Assist with claims corrections and follow up on provider or member questions regarding claims payments.
• Generate provider faxes and member letters and perform other administrative tasks.
• Perform other duties as required.

What This Job Offers

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