Behavioral Health - Intake Specialist 150-1002

Responsible for performing health intake functions, directing members to services needed. 

•Verifies member eligibility, line of business and network affiliations for members and providers. Determines if the call is clinical and requires transfer to a clinical staff person. Will inform callers, including members, facility personnel, physicians, or other health care professionals of the utilization requirements and procedures. 

•Makes initial referrals that do not require evaluation or interpretation of clinical information to behavioral health services. May consult with licensed professionals while performing initial screening. Completes appropriate electronic certification and progress notes documentation of activities as needed. 

•Assists with specialized job tasks which may include claims repricing and follow-up with provider/member questions regarding claims payments, generate PCP and MBR letters, and other administrative tasks. 

•Performs other duties as required. 

•Possess strong oral and written communications skills. 

•Ability to reason logically and to use good judgment making solutions. 

•Successful completion of Health Care Sanctions background check. 

•Ability to organize time effectively and set priorities. 

•Ability to converse and write fluently in English. 

•Proficient in Microsoft applications. 

•High School diploma or equivalency, associate degree preferred.