Community Health Network of Connecticut, Inc. · 2 months ago
Non-Clinical Intake - Temporary Assignment
Wallingford, CT, US
Full-time, Contract
Onsite
Entry Level
$19/hr - $20/hr
1+ years expCommunity Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Non-Clinical Intake Representative. This role involves triaging incoming calls, entering authorization requests, and providing support for authorization and claim-related provider appeals.
Health CareNon Profit
Responsibilities
Responsible for triaging all incoming calls into the Utilization Management Unit, entering authorization requests into system, requesting all clinical information and forwarding any request requiring medical necessity determination to clinical staff
Provides support for authorization/claim related provider appeals
Reviews authorization requests for completeness, verifies eligibility and verifies that provider is in network
Assists with entry of hospital admissions and goods or services that require prior authorization
Maintains knowledge of covered benefits of Medicaid programs
Identifies and refers for coordination of benefits (COB) and third party liability (TPL) as appropriate
Maintains confidentiality of member specific records
Acts as preceptor to new staff
Performs other duties as assigned
Responds to telephonic requests by providers for authorization and benefit coverage for CHNCT members for all lines of business
Triages calls related to entries in the authorization portal
Performs data entry for specialty visits, rehabilitation, durable medical equipment (DME), etc
Approves services based on benefit package
Processes modification requests for existing authorizations
Interacts with providers and vendors to collect necessary medical information and office notes needed to support clinical staff in decision making
Identifies service requests for non-par providers and services outside of member benefit packages and refers to clinical staff
Qualification
Required
Secondary schooling
High school diploma or GED
1 to 3 years' related experience
Preferred
Claims processing background preferred
Excellent interpersonal/telephone communication skills
Knowledge of medical terminology, ICD10 and CPT 4 coding
Strong word processing and data entry skills
Ability to handle several tasks concurrently
Company
Community Health Network of Connecticut, Inc.
In 1995, a group of Federally Qualified Health Centers (FQHCs) came together to form Community Health Network of Connecticut, Inc.® (CHNCT), a not-for-profit managed care organization dedicated to improving medical services and health outcomes for Connecticut’s Medicaid-eligible residents.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Sylvia Kelly
President and CEO
Cory Ludington
Sr. Vice President, Administration & Chief Compliance Officer
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