• Intake Specialist Utilization Review - Health Plan

    BayCare Health System (Clearwater, FL)


    Why BayCare?

     

    At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.

    Summary:

    + Responsible for receiving and processing referrals, authorizations, and clinical documentation for healthcare services.

    + This position ensures that the necessary information is gathered for timely and accurate utilization review and that requests for care or services are processed in accordance with insurance guidelines, regulations and company protocols.

    + Accurately enter patient information, clinical documentation, and referral details into the electronic medical record (EMR) system. Maintain up-to-date and organized records for each referral or authorization case.

    + Assist Utilization Review Nurses or Specialists with follow-up tasks, including obtaining additional clinical information, if needed.

    + Help prepare reports and documentation for internal and external audits as required.

    Minimum Qualifications:

    + **Required Education:** HS Graduate or Equivalent GED

    + **Required Experience:** 1 year of experience in Customer Service, Claims, Appeals, or Healthcare Administration. Previous experience in a Healthcare setting, preferably in Utilization Review, Case Management, or Medical Intake.

    Facility:

    BayCare Health System, Admin - Non Hospital Related-BHS

     

    Status:** **Full Time, Exempt: No

     

    Shift Hours:** **8:00 AM - 5:00 PM

     

    Weekend Work:** **Occasional

    On Call:** **No

    **How often will this team member be working remotely?** Hybrid - 1 day per week in office

    Equal Opportunity Employer Veterans/Disabled

    **Position** Intake Specialist Utilization Review - Health Plan

    **Location** Clearwater:Park Place | Business and Administrative | Full Time

    **Req ID** 128905