Intake Specialist I - Part Time

Utah Retirement Systems•Salt Lake City, UT

1d•Hybrid

About The Position

PEHP’s Intake Team plays a mission critical role in PEHP’s centralization of core operational functions by processing all inbound documents. The Intake Specialist is responsible for reviewing, approving, and processing routine forms, ensuring that data is accurately loaded into the system, and forwarding documents to other departments as appropriate. The Intake Specialist must understand PEHP forms, processes, and operation systems. Successful performance of this position requires a high-level of commitment, attention to detail, and a willingness to understand the various programs and processes within PEHP.

Requirements

High school diploma or equivalent.
Working knowledge and ability of various office management software systems related to alpha-numeric and document management.
Ten-key operation.
Microsoft Office Suite.
Calculating figures and amounts such as discounts, percentages, fractions, and ratios.
Working knowledge of PEHP claims adjudication policies, procedures, and processes.
Working knowledge of intricacies related to medical and dental claims.
Working knowledge of PEHP enrollment processes.
Working knowledge of basic medical and dental terminology.
Working knowledge of PEHP Medical, Dental, Life, Long Term Disability, Accidental Death & Dismemberment, and Pharmacy benefits, policies, limitations, and exclusions.
Working knowledge of PEHP appeals process policies.
Excellent communication skills.
Ability to read, analyze, and interpret software operational procedure manuals, technical procedures, and regulations.
Interpersonal communication skills and public relation skills.
Communicate effectively verbally and in writing.
Ability to follow written and verbal instructions.
Ability to prioritize work.
Ability to review reports.
Ability to perform within deadlines.
Ability to work well in a team environment as well as independently.
Ability to multi-task by handling a variety of duties in a timely and efficient manner.
Ability to follow through with assignments.
Ability to deal effectively with stress caused by workload and time deadlines.
Must always demonstrate judgment, high integrity, and personal values consistent with the values of URS.

Nice To Haves

PEHP experience is preferred.

Responsibilities

Processing routine data and forms related to demographics, enrollment, prior authorization, and provider contracting when submitted electronically, including the Message Center, or by paper.
Ensuring routine forms are accurate and complete before processing.
Ensuring approved forms are accurately loaded into the system.
When applicable, finalizing entity records loaded into the system.
Reviewing, indexing, and routing of documents submitted to PEHP.
Indexing files into document retention systems.
Creating and finalizing entity records and initiating workflows within the PEHP core administration systems.
Determining system processes and routing workflows to appropriate departments, including claims submissions, appeals and payment correction requests, recovery requests for overpayments, subrogation, and third-party liability, returned mail, incoming scanned mail, and documents related to enrollment, prior authorization, and provider contracting that contain data or forms that are not routine.
Adhering to established guidelines and standard operating procedures to enhance efficiency and maintain compliance of internal and external service levels.
Performing data processing and record finalization while verifying and ensuring accuracy of information within the system and assuring timely handling of documents.
Reviewing daily, weekly, monthly, and quarterly reports on all key performance indicators.
Responding to requirements, goals, priorities, and review of input data as assigned by the Intake Supervisor.
Maintaining regular and reliable attendance.
Maintaining strict confidentiality.
Performing other related duties as required.