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Trustmark Intake Coordinator - Healthcare Management in Remote, United States

Join a passionate and purpose-driven team of colleagues who contribute to Trustmark’s mission of helping people increase wellbeing through better health and greater financial security. At Trustmark, you’ll work collaboratively to transform lives and help people, communities and businesses thrive. Flourish in a culture where appreciation, mutual respect and trust are constants, not just for our customers but for ourselves. #GD

For more than four decades, Trustmark Health Benefits has crafted integrated, flexible, and tailored employer health plan designs that seamlessly meet specific business needs and delight members. Each of our offices around the country is managed locally, by industry veterans who understand the dynamics of the markets they serve. Our responsive and empathetic service teams provide the highest level of support for employers and members. Our local expertise and service represents our national strength. We are an independently operated subsidiary of Trustmark Mutual Holding Company.

Trustmark Health Benefits is currently seeking Intake Coordinators with a passion for exceptional service. The Intake Coordinator is responsible for collecting demographic information required for the certification of inpatient, outpatient and alternate site care. This position is also accountable for entering this data into the healthcare management system. Emphasis is on customer service.

Responsibilities:

  • Respond to incoming healthcare Management calls and faxes to determine the reason for the call. The intake coordinator determinations precertification requirements, continues stay review, discharge planning, case management referrals, etc. using system notes and department guideline manuals and triages the call or fax appropriately.

  • Responsible for reviewing faxes and determining is all clinical criteria is present to submit to the Utilization Management Team to complete a review.

  • Ability to advise status of a request that meets the criteria of an auto approval based on standard clinical criteria sets.

  • Advises callers of the Utilization Management certification requirements based on client information located on the HCM Group Matrix and within TruCare.

  • Offers to connect callers to the benefit department for clarification of plan benefits.

  • Collects all pertinent demographic information as it relates to the certification of inpatient, outpatient, and alternative site care and enters into the HealthCare Management Information system, documenting per departmental procedures. Accurately collects Diagnosis Codes, CPT, HCPS codes and understands how to categorize the service based on those codes.

  • Initiates outbound calls to request clinical information and discharge dates.

  • Assist on help desk answering questions that the intake team has regarding a call that they are on.

  • Completes voicemail transcription from the queue and returns calls for confirmation of data and initiation of the certification processes as appropriate.

  • Completes administrative lack of information process for non-receipt of clinical information.

  • Responsible for verifying charges-to-date on an individual case and providing appropriate notification and/or referral per current guidelines

  • Participates in quality improvement initiatives such as verifying clinical is received appropriately for reviews of the auto approval process.

  • Retrieves data from vendor portals and inputs information into TruCare to initiate a utilization review and/or case management referral when appropriate.

  • Enrolls members into referral programs when applicable.

  • Triages inquiries sent to the HCM department via the claims inquiry or cert request queues.

  • Acts as a liaison to the privacy office for our PAR process.

  • Completes URAC assessments and training to ensure full understanding of URAC processes to assist in reaccreditation if selected.

  • Assists in the administrative preparation and filing of physician review referrals to contracted sub-vendors.

  • Testing of rules added to the BRE tables and assists with upgrade testing.

  • Assist providers in navigating into ProAuth and trouble shoot basic questions and issues. Work tasks related to corrupt files submitted into proAuth.

  • Prioritize daily work assignment to meet division goals and customer requirements.

  • Collaborate as necessary with internal and external customers to achieve excellent service results.

  • Other duties and special projects as needed/assigned by HCM Management.

  • Assist on help desk answering questions that the intake team has regarding a call that they are on.

  • Other duties as assigned

Minimum Requirements:

  • High School Diploma or GED equivalent

  • Communicate in a positive and effective manner in both oral and written communication;

  • Read and interpret documents, criteria, instructions, and policy & procedure manuals;

  • Write/create routine correspondence and reports;

  • Speak effectively with clients, physicians, providers, families in crisis and community agencies as well as co-workers and senior management;

  • Add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals;

  • Compute rate, ratio and percent;

  • Apply common sense understanding to carry out instruction furnished in written, oral or diagram form;

  • Deal with problems involving several concrete variables in standardized situations;

  • Evaluate problems, develop alternative solutions and identify trends and patterns;

  • Capable of working in an environment that requires organization and prioritization in order to address time sensitive assignments;

  • Excellent interpersonal skills;

  • Perform multiple tasks simultaneously;

  • Maintain high level of confidentiality, flexibility and willingness to learn new tasks;

  • Work in a dynamic team-oriented environment;

  • Work independently with minimal supervision or instruction.

  • Ability to work between the hours of Monday through Friday, 10:00 a.m. to 6:00 p.m. with occasional flexibility to work until 7 p.m.

Preferred Requirements:

  • Medical coding and/or transcription certification

  • Previous experience in a healthcare or insurance environment

  • Previous experience in a call center

  • Experience with Microsoft Office

Come join Trustmark! Join a team that will not only utilize your current skills, but will enhance them as well. Trustmark benefits include medical/dental/life insurance, very generous 401(k) plan, wellness initiatives and much more!

If you are a Colorado resident and this role is a field-based or remote role, you may be eligible to receive additional information about the compensation and benefits for this role, which we will provide upon request.

Benefits Include:

  • Paid Time Off

  • Paid Holidays

  • 401K

  • Health, Dental, and Vision

  • FSA and HSA

  • Basic Life Insurance & Supplemental Life

  • Short/Long Term Disability

  • EAP

  • Back-up Care for Children, Adults and Elders

  • Wellness Program

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, or disability

Required Skills

Required Experience

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