Clinical Intake Specialist

The Clinical Intake Specialist is responsible for processing telephonic and fax notifications, referrals and requests for authorization from members, facilities and physician offices.

The Clinical Intake Specialis focuses on building and updating referrals and authorization requests in the member record that are essential to conducting the clinical review process and enabling accurate and timely claims payment. This position leverages strong communication and customer service skills and requires accurate and proficient data entry skills.

This position is eligible for the following personas: eWorker, mobile, resident.

The Team

As an integral part of the Clinical Intake team, the Clinical Intake Specialist provides quality customer service in a timely manner while consistently supporting the needs of our members, providers and accounts.

Training

New hire training for Clinical Intake associates runs for approximately 3 months.

• During this time new hires will be required to be in house for up to two days per week.
• In-house training will be conducted at the Hingham building.
• In-house days will be scheduled for the Tuesday and Wednesday of each week and may be adjusted based on holidays.

Key Responsibilities:

• Handle protected health information consistent with department and company policies and regulatory requirements.
• Follow identified workflows, plan requirements, clinical guidelines, and make sound, objective decisions.
• Employ active listening skills, demonstrate patience and empathy with our internal and external customers
• Meet or exceed department established key performance indicators.
• Handle difficult customers tactfully, courteously and professionally.
• Adhere to assigned schedules to ensure appropriate phone queue coverage.

Key Qualifications:

• Comfort and proficiency with the use of computers and technology (ability to work within multiple computer and telephone applications and systems; ability to key in data proficiently and in real time during a phone call; comfort quickly learning and effectively working within a variety of media).
• Productivity - ability to prioritize and manage assigned workload to accomplish full slate of targeted activities.
• Demonstrates a commitment to quality and projects a positive, team-oriented demeanor.
• Critical thinking / problem solving skills (ability to analyze information to construct effective solutions).
• Ability to articulate complex concepts, verbally and in writing, in decisive and focused manner, with professional and engaging tone.
• Demonstrates awareness, attitude, knowledge, and skills to work effectively with a culturally and demographically diverse population.

Education and Experience:

• High school diploma or equivalent required.
• 6-12 months of relevant experience.
• Preferred customer service experience in health care, call center or corporate office.
• Knowledge of medical terminology is helpful.

High school degree or equivalent required unless otherwise noted above

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that theconfidence gapandimposter syndromecan prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting ourCompany Culturepage. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join ourTalent Communityto stay "in the know" on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.