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    Utilization Review Intake Specialist - Covington, United States - VirginPulse

    VirginPulse
    VirginPulse Covington, United States

    2 weeks ago

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    Description

    Now is the time to join us

    Virgin Pulse and HealthComp are now Personify Health. The industry's first personalized health platform company combines health, wellbeing, and navigation solutions to deliver powerful outcomes to businesses and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we're shaping a healthier, more engaged future.


    In this role you will wear many hats, but your knowledge will be essential in the following:

  • Answer and route all incoming phone calls
  • Provide accurate information to internal and external customers regarding pre-certification process, including gathering demographic, non-clinical, and/or provider data for pre-certification via phone, fax, inter/intranet, Eldorado/Case Pac computer programs
  • Review service requests and manage the requests as efficiently as possible involving the appropriate department as needed
  • Perform data entry and maintain complete documentation of case information; assist in document maintenance or revisions; compile monthly reports; maintain logs and files
  • Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis

    • You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.


    What you bring to the Personify Health team:

    In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

  • Prior experience in customer service and/or medical background
  • Prior insurance and/or claims background
  • Prior experience in a medical front office or hospital patient intake, medical claims processing, or an equivalent combination of education and experience
  • Associate degree preferred in business, management, or related field

    • You also take pride in offering the following Core Skills, Competencies, and Characteristics:

  • Ability to safely and successfully perform the essential job functions with or without a reasonable accommodation, including meeting qualitative and/or quantitative productivity standards.
  • Ability to maintain regular, punctual attendance.
  • Ability to sit for 6-8 hours.
  • Constant use of computer keyboard and mouse; repetitive use of both hands.
  • Occasional to frequent twisting of neck; frequent bending of neck and at waist.

    • No candidate will meet every single desired qualification. If your experience looks a little different from what we've identified and you think you can bring value to the role, we'd love to learn more about you

    Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

    #LI-REMOTE

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