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VCC Intake Coordinator

Company Name:Brattleboro RetreatVCC Intake CoordinatorDepartment: VCCSchedule: Full TimeShift: Day ShiftHours: 40 HourJob Details: BC/BS of vermontand the Brattleboro Retreat have partnered to form a unique integrated approach to meeting the healthcare needs of Vermonters living with co-occurring medical and mental issues. We are looking for experienced licensedVermontclinicians to jon our efforts, The jobswill be located at the BC offices inBerlin,VT.Please contact Peter Albert for details. This partnership is something new and important, don't miss out in this opportunityContact:Peter AlbertJob Summary: The Intake Coordinator s primary responsibility is to facilitate and coordinate phone, fax, or electronic preadmission/admission reviews, prior approvals and referral requests through the medical and/or MHSA review cycle in compliance with regulatory and accreditation requirements. This includes verifying member eligibility, gathering clinical, demographic and member identification data, generating and performing quality assurance of correspondence, entering authorizations to ensure appropriate claims processing, and maintaining electronic medical records. The Intake Coordinator may determine the medical appropriateness of certain requested services by applying medical and/or MHSA policy criteria and algorithms, forwarding more complex cases or cases requiring a medical necessity determination, to clinical reviewers.The Intake Coordinator is also responsible for answering department phone calls and evaluating issues and questions from internal and external customers. The Intake Coordinator provides exceptional customer service when interacting with all internal and external customers and is a resource to other business units for in-depth inquires and escalated issues while always maintaining the highest level of confidentiality.Note: This position is located inBerlin,VTKNOWLEDGE, SKILLSANDABILITIES REQUIRED Subject Matter Expertiseo Proficient understanding of all benefits and productso Proficient understanding of the claims adjudication and data systemso Thorough understanding of medical terminology and medical coding, to include ICD-9, ICD-10, HCPCS,CPT4, and DSM if applicableo Thorough understanding of all regulatory and accreditation standards pertaining to Case/Care Management Computer Skills (or other Technical skills)o Proficient in use of MS Office Applications (specifically Outlook, Word and Excel), specialized computer applications, internet browsing, and complex phone systems. Familiarity with data availability and sources including organizational reporting Communication Skillso Strong written and oral communications skills, with advanced listening skills to be able to identify provider and subscriber concernso Ability to read and comprehend written text with attention and appreciation for detail Interpersonal Skillso Strong interpersonal skills, including the ability to effectively maintain a consistently respectful, pleasant, courteous, and positive manner in responding to all member and provider telephone inquiries, including those from angry or difficult customerso Demonstrate behaviors that encourage cooperation, support and teamworko Demonstrate behaviors that recognize the rights of members/patientso Demonstrate regard for the concern, courtesy, dignity and importance of all internal and external partners, members/patients and family members to ensure a professional, caring, service oriented environmento Demonstrated leadership experience and ability. Organizational Abilitieso Strong organizational skillso Ability to work independently, demonstrate attention to detail with accuracy, and utilization of resourceso Ability to multi-task/prioritize high volume while maintaining quality, accreditation and regulatory standards.o Demonstrate flexibility and adaptability with a calm demeanor and understanding of the situation Analytical Skillso Ability to research data and information and identify themes and courses of actiono Ability to analyze documents and processes to identify gaps and areas of non-compliance Business Insighto Demonstrate understanding of the care management process and its business implicationso Awareness of federal and state policies and healthcare trends that may impact care management Safety and Preparednesso Demonstrates safe work practices including how to report safety issues, proper body mechanics and use of protective gear if applicableo Demonstrates understanding of standard safety precautions for infection controlo Demonstrates and verbalizes proper procedure for responding to fire drills or other disastersQUALIFICATIONS:High school diploma with associates or bachelors degree in a related health care field preferred. 3-5 years experience in the healthcare industry, preferably health insurance, is required..PLEASE READ: Your computer may have specific settings that block popup boxes and forms. 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