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Role Description

The Intake Representative assists providers in submitting documentation for case management, utilization review, and other medical management services. This role is responsible for entering case information, validating documentation for completeness, and communicating with providers regarding case status and required information. The Intake Representative plays an important role in ensuring requests are accurately documented and ready for clinical review while maintaining clear communication with providers and internal teams.

Key Responsibilities

• Validate requests submitted through the Comagine Health Provider Portal for accuracy and completeness.
• Screen cases for required medical information and determine if documentation is sufficient for clinical review.
• Obtain additional information from providers or client systems when necessary.
• Enter and validate case information within the care management system.
• Respond to inbound provider calls and document interactions appropriately.
• Conduct outbound calls to providers regarding case status, additional documentation needs, or review outcomes.
• Process requests after physician review, ensuring determination language and documentation are complete before sending notifications.
• Notify providers of review outcomes, additional information needed, or potential denial of services as required by contract.
• Participate in orientation and training of other intake staff.
• Support internal quality review processes and provider outreach activities as requested.

Additional Responsibilities (Case Management Support)

• Arrange ancillary authorization requests such as transportation or accommodations when applicable.
• Obtain customer consent for care management services.
• Coordinate non-clinical activities with providers, facilities, and other stakeholders.
• Assist with case closure activities following review by clinical staff.

Qualifications

• High school diploma or equivalent.
• Equivalent combination of education and relevant work experience may be considered.

Requirements

• 2 years of related work or customer service experience.
• 1 year of healthcare experience.

Preferred Qualifications

• Post-secondary education or certification in a related field.
• 2 years of healthcare experience.
• Experience as a medical assistant, nursing assistant, or similar healthcare support role.

Skills and Competencies

• Intermediate understanding of medical terminology.
• Proficiency with Microsoft Office Suite.
• Strong communication and customer service skills.
• Ability to document information accurately in a care management system.
• Ability to manage multiple tasks and communicate effectively with providers and internal teams.

Benefits

• Medical, dental and vision insurance.
• Paid time off for vacation, illness, and volunteering.
• Retirement savings plan with employer contribution.
• Adoption financial assistance.
• Paid parental leave.
• And much more!

Equal Opportunity Employer

Comagine Health is an equal opportunity employer and is committed to creating a diverse, equitable, and inclusive workplace.