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Corporate Functions & Operations WellCare - Clinical Support Careers

Intake Operations Coordinator Job

Full Job Title: Intake Operations Coordinator

Job Number: 1701873

Location: Columbia, MO

Date Posted: 4-26-2017

This position supports MissouriCare, which is a member of the WellCare group of companies.
The Ops Intake Coordinator processes phone and fax authorization requests for medical services from physicians and hospitals ("providers") in an efficient, accurate and customer-focused manner.
DEPARTMENT: Health Services-Utilization Management
REPORTS TO: Manager, Clinical Care
Essential Functions:
  • Effectively handles authorization requests and inquiry phone calls from providers, balancing excellent customer service with efficiency
  • Follows appropriate procedures for checking member eligibility, authorization history and provider network participation status
  • Based on the information provided by the provider and gathered from computer systems, determines the appropriate handling of each inpatient or outpatient request
  • Utilizes online tools to determine authorization requirements based on the type of service requested, the location of the service and the provider specifics
  • Accurately enters authorization requests into WellCare's system
  • Based on authorization rules and urgency, either approves the authorization request or escalates to a nurse for review
  • Communicates authorization specific to providers either verbally on the phone calls or written through fax.

*LI-SM1

Education/Experience:
  • High School Diploma
  • 1 year customer service experience
  • Knowledge of medical terminology and/or experience with CPT and ICD-9/10 coding, preferred
  • Call Center experience, preferred

Computer Skills:

  • Knowledge of Microsoft Office including Outlook,Word and Excel
  • Ability to manage multiple computer programs to process a single request
  • Proficient in data entry
  • Knowledge of Sidewinder and Peradigm systems, preferred

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Last Updated On: 12/9/2015