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Intake Processor



Care Coordination

French Camp, CA
 • 
ID: 1735-942
 • 
Full-Time/Regular

Do you want to work with an expanding team that values growth in addition to working for a company with fantastic benefits? We are seeking an Intake Processor who is passionate about serving our community and providing high quality care to our members. This is a brand new position on this team to support the growth our company is experiencing.

 

What You Will Be Doing:
In this role, you will be responsible for initial processing of provider requests for authorization.

 

The Day-To-Day:

  • Reviews and verifies authorizations received from provider portal, fax or other sources for accuracy and completeness, including but not limited to eligibility, clinical information and other supporting documentation.
  • Processed auto-approve items as directed and per guidelines.
  • Obtains required documentation and information from a variety of internal and external resources, including but not limited to providers; routes to clinical staff for review.
  • Monitors deferrals; contacts providers and generates required letters for approval; distributes as required.
  • Builds cases by entering data into appropriate systems.

Required Skills

What You Bring:

Required

  • Produces work that is accurate and complete.
  • Produces the appropriate amount of work.
  • Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
  • Rebounds from setbacks and adversity when facing difficult situations.
  • Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
  • Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
  • Strong oral and written communication skills, with ability to express self clearly and professionally, with appropriate grammar and spelling, and document according to standards.
  • Strong listening skills, with the ability to accurately receive and understand messages.
  • Basic conflict resolution skills, with the ability to use tact and diplomacy to diffuse emotional situations.
  • Ability to work independently and as part of a team.
  • Demonstrates commitment to HPSJ’s strategy, vision, mission and values.
  • Ability to read, understand and apply complex written guidelines, instructions and other materials.
  • Ability to compare and discern the difference between multiple sets of data or information.
  • Strong organizational skills, with the ability to effectively prioritize and complete multiple tasks.
  • Basic problem solving and analytical skills, including the ability to perform routine analysis and solve problems using identified data and information.
  • Basic arithmetic skills.
  • Basic skills in Windows, Excel, Word and Outlook.
  • Ability to navigate multiple systems and resources simultaneously.
  • Ability to treat confidential information with appropriate discretion.
  • Ability to speak and be understood in English.

 

Preferred

  • Knowledge of Medi-Cal programs and benefits
  • Knowledge of managed care
  • Knowledge of medical benefits and exclusions
  • Knowledge of medical terminology
  • Knowledge of ICD and CPT coding
  • May require proficiency in one of HPSJ’s threshold languages (as defined by HPSJ’s Cultural and Linguistic Program).

Required Experience

What you Have:

Required

  • High school diploma or general education degree; and
  • At least two years of general clerical or data entry experience; or
  • Equivalent combination of education and experience.

 

Preferred

  • Associate’s Degree
  • Experience in a similar position
  • Experience working with Medi-Cal beneficiaries and providers.

 

What You Will Get:

  • HPSJ Perks:
    • Competitive salary
    • Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
    • Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
    • CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
    • Two flexible spending accounts (FSAs)
    • Employer-Paid Term Life and AD&D Insurance
    • Employer-Paid Disability Insurance
    • Employer-Paid Life Assistance Program
    • Health Advocacy
    • Supplemental medical, legal, identity theft protection
    • Access to exclusive discount mall
    • Education and training reimbursement in addition to employer-paid elective learning courses.
  • A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
  • A shorter commute ­– if you’re commuting from the Central Valley to the Bay Area.
  • Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects. 

 

Our Vision:

  • Continuously improve the health of our community.

Our Mission:

  • We provide healthcare value and advance wellness through community partnerships.

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