Intake Specialist - Home Care

ThedaCare • Appleton, WI

370d • Hybrid

About The Position

The Intake Specialist coordinates telephonic and electronic referrals to ensure continuity of care and completion of the provider's care plan for the patient, family, and referral source. Uses customer service and critical thinking skills to assist customers and referral sources. Serves as a liaison between customers, insurance companies, and referral sources. Serves all external and internal customers in a compassionate manner, answering a high volume of requests from customers, referrals, and team members.

Requirements

• High School diploma or GED preferred
• Must be 18 years of age
• Two years of experience in the healthcare, insurance, or customer service industries

Responsibilities

• Answers inbound phone calls in a call center model regarding new referrals, reorders, and questions to meet the customer's needs according to their plan of care from their provider.
• Advocates, initiates, and coordinates referrals to meet the customer's plan of care from the provider in an efficient and timely manner.
• Assesses the level of urgency of a patient need and prioritizes accordingly.
• Assesses, gathers, and coordinates clinical and nonclinical referrals for proper documentation, ensuring the insurance guidelines, regulatory guidelines, and qualifications are met to ensure a defect-free order and claim.
• Responds to customer inquiries by researching documentation and insurance guidelines.
• Consults with insurance providers, hospitals, clinics, and other medical entities through written or verbal methods to complete a referral accurately to meet the patient's plan of care.
• Verifies and generates appropriate documentation and follow-up for accuracy of patient information to ensure accurate billing and reimbursement.
• Provides regulatory education to customers and referral sources.
• Analyzes data to ensure accuracy with insurance resources and guidelines, regulatory and reimbursement manual and criteria, HCPC and ICD-10 coding manuals, provider directories, and other online resources to ensure accurate billing and reimbursement.
• Maintains proper safety measures for customers and team members including infection prevention, safe equipment usage, body mechanics with proper lifting, and positioning techniques.

Benefits

• Lifestyle Engagement: health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support
• Access & Affordability: minimal or zero copays, team member cost sharing premiums, daycare

What This Job Offers

• Job Type: Full-time
• Industry: Hospitals
• Education Level: High school or GED