Utilization Review Intake Specialist

Personify Health

1d•$15 - $21•Remote

About The Position

Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future. Ready to Bridge Members and Providers Through Seamless Intake Support?We're seeking a customer-focused professional who can perform critical clerical and administrative duties in the utilization management division while managing high volumes of customer interactions with precision and care. As our Utilization Review Intake Specialist, you'll provide accurate information about pre-certification processes while gathering essential demographic and provider data that supports clinical decision-making. This flexible position is ideal for candidates seeking reduced hours while making meaningful impact, with weekend availability required. What makes this role different: ✓ Flexible schedule: Reduced hours with required weekend availability to support healthcare operations and member needs ✓ First impression impact: Serve as initial point of contact for pre-certification inquiries, setting tone for positive customer experience ✓ Process expertise: Master pre-certification processes while providing accurate information to internal and external customers ✓ Data integrity: Ensure complete documentation and data accuracy that supports downstream utilization review decision-making

Requirements

Associate degree preferred in business, management, or related field
Prior experience in customer service and/or medical background
Experience in medical front office, hospital patient intake, medical claims processing, or equivalent combination of education and experience
Proficiency in Microsoft Excel, Word, and Outlook
Accurate data entry skills (40wpm minimum)
Strong written and verbal communication skills for diverse customer interactions
Ability to manage high volumes of customer service calls while maintaining quality and accuracy
Capability to organize, prioritize, and multitask in fast-paced, deadline-driven environment
Demonstrate ability to work independently with excellent judgment and decision-making
Strong customer orientation with commitment to providing accurate, helpful information
Flexibility to work weekends as required to support operational needs
Adaptability to changing priorities and ability to involve appropriate departments for complex requests

Nice To Haves

Prior insurance and/or claims background preferred
Knowledge of medical terminology; ICD-10, CPT & HCPCS coding desirable
Ability to navigate various computer software programs for data collection and documentation

Responsibilities

Manage customer interactions: Answer and route all incoming phone calls while providing accurate information to internal and external customers regarding pre-certification process.
Gather critical information: Collect demographic, non-clinical, and provider data for pre-certification using phone, fax, inter/intranet, and various computer software programs.
Review and route requests: Analyze service requests and manage them efficiently, involving appropriate departments as needed for optimal resolution and timely processing.
Maintain comprehensive documentation: Perform accurate data entry and maintain complete case information documentation while assisting in document maintenance, revisions, and monthly report compilation.
Meet performance standards: Achieve productivity, quality, and turnaround time requirements on daily, weekly, and monthly basis while supporting team excellence.
Manage high-volume operations: Handle multiple customer service calls while maintaining logs, files, and organized documentation systems in fast-paced environment.

Benefits

Flexibility that actually works:
Part-time schedule designed around your availability and life priorities
Remote work that eliminates commute stress
Clear expectations and boundaries that respect your time investment
Growth without limits:
Access to learning and development opportunities alongside full-time colleagues
Mentorship and skill-building that translates to career advancement
A culture that energizes:
People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation
One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges
We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results
Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable
The practical stuff:
Competitive hourly compensation that values your expertise
Technology and equipment support to set you up for success