Intake Coordinator

Customer Service Operations Park Ridge, Illinois


Description

Position at Clear Spring Health

Group1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001’s culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets – our employees.

Group1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001’s culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets – our employees.

Company Overview

Clear Spring Health is part of Group One Thousand One (“Group1001”), a customer-centric insurance group whose mission is to make insurance more useful, intuitive and accessible so that everyone feels empowered to achieve financial security.  Clear Spring Health is dedicated to helping seniors protect their health and well-being by providing Medicare Advantage plans in select counties of Colorado, Illinois, North Carolina, and Virginia, plus Georgia and South Carolina.  In addition, Clear Spring Health sponsors Medicare Prescription Drug plans in 42 states.   

Group 1001, and its affiliated companies, is strongly committed to providing a supportive work environment where employee differences are valued. Diversity is an essential ingredient in making Group 1001 a welcoming place to work and is fundamental in building a high-performance team. Diversity embodies all the differences that make us unique individuals. All employees share the responsibility for maintaining a workplace culture of dignity, respect, understanding and appreciation of individual and group differences.

 

Job Summary

Referral Coordinator will ensure the effective management of all incoming referrals. Handles a wide variety of tasks associated with referral tracking to ensure timely start of services. Performs multiple activities to assist medical management department. Oversees the referral and intake process while coordinating with the Medical Management Department.

 

Main Accountabilities:

  • Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
  • Ensure that referrals are addressed in timely manner.
  • Complete and accurately track patient demographics and eligibility.
  • Enter admissions/referrals into the system and transfer to appropriate UM / Transition of Care Coordinator.
  • Assemble information concerning member’s clinical information and referral needs.
  • Assist members and providers in problem solving issues related to health care and social barriers (e.g. request interpreters as appropriate, transportation or prescription assistance)
  • Complete and accurate data entry.
  • Maintain ongoing tracking and appropriate documentation on referral tracking
  • Communicates with UM staff any issues that need further follow-up
  • Merge temporary files with permanent files on a monthly basis.
  • Send notification letters to medical groups for admissions that are switched from pending to authorized admissions.
  • Send provider non-payment letter to member, providers and medical groups for members that did not become eligible on date of service.
  • Notifies IT and Enrollment departments of eligibility discrepancies between CCMS and MEDI.
  • Assist entire department with other tasks as assigned, including, but not limited to:
    • Creating prenatal events from admission notification.
    • Verifying demographic information
    • Fax letters/notifications as directed
  • Other duties as assigned.

Qualifications:

  • High school diploma, general education degree or equivalent;
  • Customer service experience, preferred;
  • Healthcare experience a plus
  • Ability to multitask efficiently
  • Ability to stay calm when customers are stressed or upset.
  • Flexibility to work different shifts (including evenings, weekends, or holidays)
  • Ability to thrive in fast-paced environment and multitasking

Skills and Abilities:

  • High attention to details
  • Effective communication skills both verbal and written
  • Computer skills, a must
  • Proficient in the use of Microsoft Office, Excel and Power Point
  • Planning and organizing
  • Excellent customer service skills
  • Ability to work both as a team and independently
Ability to engage professionally with members, organizational staff and providers