Intake Specialist

Avera Health • Sioux Falls, SD

358d • $18 - $23

About The Position

The position at Avera Health involves acting as the primary access point for customers and referral sources. The role requires the individual to serve as the primary intake person for incoming requests across multiple sites, screening referrals and responding according to priority levels set by the Access Services Manager. Responsibilities include registering patients in the computer system, completing insurance eligibility and benefit verification, and maintaining knowledge of payer regulations and home care services. The position also involves utilizing workflow software for tracking orders and ensuring compliance with regulatory requirements.

Requirements

• High School or GED Equivalent

Nice To Haves

• Certificate from college or technical school or 3-6 months experience and/or training

Responsibilities

• Serves as primary intake person for incoming requests for multiple sites and appropriately screens incoming referrals.
• Registers the patient in the computer system utilizing multiple resources to gather information.
• Forwards multi-discipline orders to appropriate agencies and completes necessary steps to facilitate timely admission.
• Completes insurance eligibility and benefit verification, gathers medical necessity documentation, and negotiates pre-authorization as necessary.
• Maintains current knowledge base of all payer's unique rules/regulations, coverage criteria, payer contracts and in-network providers.
• Reviews documentation and determines medical necessity coverage per specific payer guidelines and completes Advance Beneficiary Notices (ABN)/waivers when required.
• Maintains an up-to-date knowledge of home care services and service area.
• Utilizes workflow software to track all orders for performance productivity, responsiveness, and quality standards.
• Ensures compliance with state, federal, and accreditation regulatory requirements.
• Achieves and maintains a thorough knowledge base of Meditech Home Care and assists in planning and application of the system.
• Assists in the development of new programs and project coordination relevant to data collection for productivity outcomes.

Benefits

• PTO front-loaded for eligible hires
• Free health insurance options for full-time single coverage on Avera High Deductible Health Plan
• Up to 5% employer matching contribution for retirement
• Career development guided by hands-on training and mentorship

What This Job Offers

• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees