Intake Representative I
Company: Centene Corporation
Location: Rancho Cordova
Posted on: November 21, 2022
You could be the one who changes everything for our 26 million
members as a clinical professional on our Medical Management/Health
Services team. Centene is a diversified, national organization
offering competitive benefits including a fresh perspective on
Position Purpose: The Intake Representative I enters specific
data/information from physicians' requests into a medical
management authorization system, achieving required production
* Validates patient and medical provider demographic information
including correct selection of a medical provider by specialty for
* Determines whether patients are eligible to receive health care
benefits under the insurance program by determining the patients'
status/eligibility the Primary Care Manager (doctor) type, and the
appropriate referral/authorization path.
* Contacts medical provider offices by telephone, and makes
confirmation calls to patients for all urgent requests. Uses sound
judgment in making decisions in order to keep the
referral/authorization process moving forward in accordance with
contractual timeliness standards.
* Follows step-by-step instructions, including redirecting patients
into the provider network for care, as required by contractual
* Formulates brief sentences/paragraphs from referral/authorization
orders and prepares correspondence in business letter format to
provide clinical information to servicing providers.
* Generates letters and reviews to validate that they are going to
the correct providers/patients, and that the provider/patient
demographics and reason(s) for services to be rendered are
* Accounts accurately for personal production via a production
report that includes outcome data such as closed transactions,
duplicative transactions and requests.
* Meets goals and produces results through tracking performance,
improving work processes, and prioritizing work and tasks.
* Achieves successful solutions by reviewing situations and
ensuring a full understanding before taking steps to resolve. Key
components of this responsibility are objectively identifying
problems, recognizing patterns, and determining solutions.
* Works as a team member; cooperates, assists and collaborates with
co-workers to achieve goals and department success, and takes
personal responsibility for achieving outstanding customer
Education/Experience: High School diploma or equivalent; college
course work preferred. Six months experience in a production/data
entry environment performing alpha and numeric data entry in a
healthcare related organization such as managed care,
claims/billing, health insurance, customer service, call center, or
claims office preferred. License/Certification: Medically based
trade school diploma/certification, desired.
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Centene Corporation, Rancho Cordova , Intake Representative I, Other , Rancho Cordova, California
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