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Corporate Functions & Operations WellCare - Operations Support Careers

Operations Intake - Coordinator Job

Full Job Title: Ops Intake Coordinator

Job Number: 1702262

Location: Tampa, FL

Date Posted: 6-1-2017

LOCATION: Idlewild Avenue, Tampa, FL
DEPARTMENT: Operations, Provider Communications
REPORTING TO: Supervisor, Operations
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.
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
Education/Experience:
  • High School Diploma
  • 1 year customer service experience
  • Knowledge of medical terminology and/or experience with CPT and ICD-9 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