Intake Coordinator

Title: Intake Coordinator

Location: ONSITE, Downtown, Pittsburgh, PA

Job Description: This job captures all inbound appeals and grievance requests from providers and/or subscribers. The incumbent assesses the request, conducts all necessary research such as verifying benefit coverage for the patient, denial codes, par or non-par provider status and then creates the case (data entry) in the online processing system. Ensures all accurate information is entered at the onset of the process to ensure adherence to all regulatory compliance requirements and service level agreements. The requests may come via fax or mail and may require checking multiple systems. The incumbent is expected to meet established quality and production standards.

Essential Responsibilities

• Obtain requests from provider, member or pharmacy via fax or mail.

• Use multiple software syst...