Intake Coordinator

Updated on 2/3/2023

Locations

Rockford, IL, USA • Remote

Experience Level

Entry

Junior

Mid

Senior

Expert

Requirements

Knowledge of medical terminology
Preferred medical office experience
One years' experience in managed care with referral entry
Detailed knowledge of medical coding; including ICD-10, HCPC's and CPT codes
Able to adapt to different situations and multitask
Must have ability to work independently, maintain organization and meet deadlines
Highly skilled in verbal and written communication
Able to problem solve, exercise initiative and make decisions
Able to communicate clearly and work effectively with co-workers, management, physicians, members, vendors and customers

Responsibilities

Team member should be able to understand how to create referral episodes in MCG and be able to enter 25-30 cases per day with assistance. Understanding their daily functions like sorting incoming faxes, answering some phone calls and working out of their own IPA folder
Team member should feel very confident with their assigned medical group and be able to enter 30-40 cases per day accurately. Able to take on more responsibilities like learning another medical group and troubleshooting issues with complex cases
Data entry of referral and pre-certification's complying with multiple sets of protocols which are built in the application
Maintains and manages strict confidentiality of all information, whether received directly or indirectly as it relates to health care services
Enter referrals and precertification's into software program accurately using ICD-10 and CPT coding as well as follow necessary guides to maintain compliance with delegation and state requirements
Answer phone calls as well as make phone calls
Responsible for accuracy and timeliness of referral and precertification's authorizations
Assists physician offices and providers with referral and precertification questions
Works with Provider Relations and Claims staff to clarify or rectify discrepancies between referrals, precertification's and claims
Assists the Clinical Services Department nursing staff in the development and maintenance of internal referral manuals
Adheres to all audit procedures
Performs other duties as assigned

Arcadia is dedicated to happier, healthier days for all. We transform diverse data into a unified fabric for health. Our platform delivers actionable insights for our customers to advance care and research, drive strategic growth, and achieve financial success. For more information, visit arcadia.io.

Why this role is important to Arcadia

An average day could include; data entry of routine referrals and pre-certification submissions. Review and approval of routine referrals and pre-certifications submitted while following established guidelines. We manage Blue Cross and Humana HMO. Initiates pre-review screening on complex referrals and/or pre-certifications and submit to the Clinical Services Department for review and finalization. Screens potential denials and submits to the Clinical Services Department. Provides clerical support with computer entry, in-going and out-going phone calls.

What Success Looks Like

In 3 months

- Team member should be able to understand how to create referral episodes in MCG and be able to enter 25-30 cases per day with assistance. Understanding their daily functions like sorting incoming faxes, answering some phone calls and working out of their own IPA folder.

In 6 months

- Team member should feel very confident with their assigned medical group and be able to enter 30-40 cases per day accurately. Able to take on more responsibilities like learning another medical group and troubleshooting issues with complex cases.

In 12 months

- Team member should be able to enter 30-40 cases accurately, have all the knowledge of each medical groups process and guidelines, trouble shoot and help others in the departments, confident in handling phone calls and providing the correct information to our clients.

What You’ll be doing

Data entry of referral and pre-certification’s complying with multiple sets of protocols which are built in the application.
Maintains and manages strict confidentiality of all information, whether received directly or indirectly as it relates to health care services.
Enter referrals and precertification’s into software program accurately using ICD-10 and CPT coding as well as follow necessary guides to maintain compliance with delegation and state requirements.
Answer phone calls as well as make phone calls.
Responsible for accuracy and timeliness of referral and precertification’s authorizations.
Assists physician offices and providers with referral and precertification questions.
Works with Provider Relations and Claims staff to clarify or rectify discrepancies between referrals, precertification’s and claims.
Assists the Clinical Services Department nursing staff in the development and maintenance of internal referral manuals.
Adheres to all audit procedures.
Performs other duties as assigned.

What You’ll Bring

Knowledge of medical terminology.
Preferred medical office experience.
One years’ experience in managed care with referral entry.
Detailed knowledge of medical coding; including ICD-10, HCPC’s and CPT codes.
Able to adapt to different situations and multitask.
Must have ability to work independently, maintain organization and meet deadlines.
Highly skilled in verbal and written communication.
Able to problem solve, exercise initiative and make decisions.
Able to communicate clearly and work effectively with co-workers, management, physicians, members, vendors and customers.

Would Love for You to Have

Knowledge of Excel basic function and PDF Converter and/or Adobe Pro
Positive disposition
Hardworking
Eager to learn daily
Very dependable
Works well with others

What You’ll Get

Flexible hours, working remote, collaborating with a great team!
Be a part of a mission driven company that is transforming the healthcare industry by changing the way patients receive care
A flexible, remote friendly company with personality and heart
Employee driven programs and initiatives for personal and professional development
Be a member of the Arcadian and Barkadian Community

About Arcadia

Arcadia.io helps innovative healthcare systems and health plans around the country transform healthcare to reduce cost while improving patient health. We do this by aggregating massive amounts of clinical and claims data, applying algorithms to identify opportunities to provide better patient care, and making those opportunities actionable by physicians at the point of care in near-real time. We are passionate about helping our customers drive meaningful outcomes. We are growing fast and have emerged as the market leader in the highly competitive population health management software and value-based care services markets, and we have been recognized by industry analysts KLAS, IDC, Forrester and Chilmark for our leadership. For a better sense of our brand and products, please explore our website, our online resources, and our interactive Data Gallery.

This position is responsible for following all Security policies and procedures in order to protect all PHI under Arcadia’s custodianship as well as Arcadia Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.

201-500 employees

Website

Energy tech company

Company Overview

Arcadia's mission is to stop climate change by breaking the fossil fuel monopoly. Their technology is lighting a cleaner path forward for everyone, from everyday consumers and small businesses to the innovators building the next generation of energy products.

Benefits

Competitive compensation and paid time off
Comprehensive medical, dental, vision, and FSA plans
Paid parental leave for everyone
Remote work opportunities
Professional development and ongoing feedback
Company stock options and 401(k)
Snacks, beverages, and regular lunches in the office
On-site gym, new parent, and wellness rooms in DC
Commuter benefits and secure bike storage
100% clean energy match for all employees

Company Core Values

Build for good
Build for all
Build with urgency
Build for simplicity
Build togethere