Behavioral Intake Coordinator

Provides customer service by receiving and answering incoming calls from behavioral health members, providers and others. Coordinates member requirements with behavioral health providers, clinical coordinators, behavioral case managers, other departments or organizations as appropriate. Assists other callers as necessary. Complies with organizational policies and procedures, regulatory requirements and other established criteria and guidelines. Maintains confidentiality of business and protected health information. Performs data entry, administrative support, reporting and other related functions as required.

Essential Functions:
  • Answers telephones according to established grade of service standards.
  • Collects and verifies information concerning eligibility, provider status, benefit coverage, coordination of benefits and subrogation.
  • Provides behavioral health customer service functions and coordinates member needs with the appropriate level of care.
  • Refers members to network behavioral health providers for outpatient evaluation and treatment.
  • Applies policies and procedures, regulatory requirements and accreditation standards to all activities.
  • Performs data entry of authorizations and customer contacts in the electronic medical management system.
  • Conducts outbound telephone calls related to coordination of behavioral health care as needed.
  • Receives and sends incoming and outgoing faxes.
  • Receives and distributes incoming and outgoing mail.
  • Assists in preparing and submitting projects, reports or assignments as needed to meet organizational initiatives and/or objectives.
  • Performs other duties as assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A High School or GED
    Candidate Experience:
    • Required 1 year of experience in member, provider or customer services with a managed care organization or call center environment and/or knowledge of basic utilization management functions.
    • Preferred Other Knowledge in medical terminology and/or experience with CPT and ICD 9 coding preferred
    Candidate Skills:
    • Intermediate Knowledge of community, state and federal laws and resources
    • Intermediate Knowledge of healthcare delivery
    • Intermediate Demonstrated interpersonal/verbal communication skills
    • Intermediate Demonstrated organizational skills
    • Intermediate Ability to work in a fast paced environment with changing priorities
    • Intermediate Demonstrated written communication skills
    • Intermediate Ability to effectively present information and respond to questions from families, members, and providers
    • Intermediate Other Ability to calculate basic math
    • Intermediate Other Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions.
    • Intermediate Other Process activities to completion
    Licenses and Certifications:
    A license in one of the following is required:
      Technical Skills:
      • Required Beginner Microsoft Outlook
      • Required Beginner Microsoft Excel
      • Required Beginner Microsoft Word
      • Required Beginner Healthcare Management Systems (Generic)
      • Required Spanish

      About us
      Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. WellCare is a Fortune 500 company, and in 2018, was recognized as a Fortune "World's Most Admired Company", ranking in the top five among the health insurance and managed care industry-a testament to the hard work and dedication of the company's nearly 9,000 associates who each day live WellCare's values and deliver on its mission to help its members live better, healthier lives. The company serves approximately 4.4 million members nationwide as of Dec. 31, 2017. For more information about WellCare, please visit the company's website at EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.