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Summary:
Sunshine State Health Plan, part of Centene, is hiring an Intake Representative I to enter and validate healthcare service requests into a medical management authorization system. This remote role requires six months of experience in a healthcare-related data entry environment and offers competitive benefits, including health insurance and tuition reimbursement.
Responsibilities:
- Validates patient and medical provider demographic information, including correct selection of a medical provider by specialty for healthcare service.
- Determines patient eligibility for health care benefits under the insurance program.
- Contacts medical provider offices by telephone and makes confirmation calls to patients for urgent requests.
- Follows step-by-step instructions, including redirecting patients into the provider network for care.
- Formulates brief sentences/paragraphs from referral/authorization orders and prepares correspondence in business letter format.
- Generates letters and reviews to validate provider/patient demographics and reasons for services.
- Accounts accurately for personal production via a production report.
- Meets goals and produces results through tracking performance, improving work processes, and prioritizing tasks.
- Achieves successful solutions by reviewing situations and ensuring a full understanding before resolving issues.
- Works as a team member, cooperates, assists, and collaborates with co-workers to achieve goals and department success.
Requirements:
- High School diploma or equivalent; college coursework preferred.
- Six months of experience in a production/data entry environment in a healthcare-related organization (managed care, claims/billing, health insurance, customer service, call center, or claims office) preferred.
- Medically based trade school diploma/certification desired.
- Must reside in Florida; Tampa Bay area strongly preferred.
- Ability to work remotely with a flexible approach to work schedules.
Benefits:
- Competitive pay.
- Health insurance.
- 401(k) and stock purchase plans.
- Tuition reimbursement.
- Paid time off plus holidays.
- Flexible work schedules (remote, hybrid, field, or office).
