Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Non-Clinical Intake Representative.

Important: This position will be filled through selected staffing agencies. Please be sure to indicate the staffing agency that you are working with on your application.

Primary Responsibilities:

Responsible for triaging all incoming calls into the Utilization Management Unit, entering referrals into system, requesting all clinical information and forwarding any referral requiring medical necessity determination to clinical staff.
Provides support for claim related provider appeals.

Tasks Performed:

Reviews all referrals for completeness, verifies eligibility and verifies that provider is in network. Assists with entry of new hospital admissions.
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.

Essential Functions:

Responds to telephonic requests by providers for authorization and benefit coverage for CHNCT members for all lines of business.
Approves services based on benefit package.
Performs data entry for specialty visits, rehabilitation, DME, etc. 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.

Desired Education: Secondary schooling

Desired Degree: High school diploma or GED

Desired Experience: 1 to 3 years' related experience

Other Qualifications: Claims processing background preferred. Excellent interpersonal/telephone communication skills. Knowledge of medical terminology, ICD9 and CPT 4 coding. Strong word processing and data entry skills. Ability to handle several tasks concurrently.

CHNCT Offers Great Benefits:

Medical, dental and vision coverage options
Flexible spending and health savings accounts
Group term life insurance
A 401(k) plan with company-match and immediate vesting
Voluntary accidental injury coverage
Tuition reimbursement and continuing education opportunities
A generous paid-leave bank and company holidays
Wellness program

We are dedicated to having a workplace where everyone feels valued, respected, and empowered to succeed. We embrace a wide range of perspectives and backgrounds, ensuring fair treatment and opportunities for all employees. We value our team’s rich array of experiences and viewpoints, which contribute to our innovative and collaborative environment.

We are committed to providing an inclusive and accessible interview process. If you require a reasonable accommodation for your interview due to a disability. Please contact us in advance if you need an accommodation.

Learn more about this Employer on their Career Site