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.
- 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.
What You Bring:
- 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.
- 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).
What you Have:
- 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.
- 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.
- Continuously improve the health of our community.
- We provide healthcare value and advance wellness through community partnerships.