Avera Health
IntakeSpecialist
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Intake Specialist at Avera Health. Skills: access point for customers and referral sources, screens incoming referrals, registers the patient in the computer system, gathers information, Forwards multi-discipline orders, completes insurance eligibility and benefit verification, gathers medical necessity documentation, negotiates pre-authorization, Maintains current knowledge base of all payer’s unique rules/regulations, coverage criteria, payer contracts and in-network providers, Reviews documen”
What You'll Achieve.
performance productivity; responsiveness; quality standards; maximize effectiveness and efficiency; cost effective and quality services; data collection for productivity outcomes; referral tracking; benchmarking
Industry & Context.
6-12 months of onsite training in Sioux Falls, SD
What They're Looking For.
Must Have
High School or GED Equivalent, visual acuity adequate to perform position duties, ability to communicate effectively with others, hear, understand and distinguish speech and other sounds
Nice to Have
Certificate from college or technical school or 3-6 months experience and/or training
What You'll Do.
Serves as primary intake person for incoming requests for multiple sites and appropriately screens incoming referrals and responds in priority levels as set forth by the Access Services Manager.
Registers the patient in the computer system utilizing multiple resources to gather information.
Forwards multi-discipline orders to appropriate sites and completes any other necessary steps to facilitate a timely hand-off.
Completes insurance eligibility and benefit verification
gathers medical necessity documentation
and negotiates pre-authorization as necessary.
Maintains current knowledge base of all payer’s unique rules/regulations
payer contracts and in-network providers.
Reviews documentation and determines medical necessity coverage per specific payer guidelines and completes Advance Beneficiary Notices (ABN)/waivers when required.
Maintains an up-to-date knowledge of products and services and coverage area.
Utilizes workflow software to track all orders for the purpose of performance productivity
and quality standards and productively participates in continuous quality improvement efforts to streamline workflows
so as to maximize effectiveness and efficiency.
Ensures compliance with state
and accreditation regulatory requirements.
Achieves and maintains a thorough knowledge base of the platform to include ongoing upgrades and assist in the planning and application of the system
as well as staff education to assure maximum utilization of the system aimed at cost effective and quality services.
Assists in the development of new programs and project coordination relevant to data collection for productivity outcomes
referral tracking and benchmarking.
How You'll Work.
Team & Collaboration
Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
Communication Scope
ability to communicate effectively with others; hear, understand and distinguish speech and other sounds
Process & Methodology
project coordination
Full Job Description
**Location:** Avera Health Broadband Lane **Worker Type:** Regular **Work Shift:** Day Shift (United States of America) **Pay Range:** _The pay range for this position is listed below. Actual pay rate dependent upon experience._ $19.50 - $25.50 **Position Highlights** **Opportunity to work remote upon the completion of 6-12 months of onsite training in Sioux Falls, SD.** **You Belong at Avera** **Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.** **A Brief Overview** Acts as the primary access point for customers and referral sources. **What you will do ** * Serves as primary intake person for incoming requests for multiple sites and appropriately screens incoming referrals and responds in priority levels as set forth by the Access Services Manager. * Registers the patient in the computer system utilizing multiple resources to gather information. Forwards multi-discipline orders to appropriate sites and completes any other necessary steps to facilitate a timely hand-off. * Completes insurance eligibility and benefit verification, gathers medical necessity documentation, and negotiates pre-authorization as necessary. * Maintains current knowledge base of all payer’s unique rules/regulations, coverage criteria, payer contracts and in-network providers. * Reviews documentation and determines medical necessity coverage per specific payer guidelines and completes Advance Beneficiary Notices (ABN)/waivers when required. * Maintains an up-to-date knowledge of products and services and coverage area. * Utilizes workflow software to track all orders for the purpose of performance productivity, responsiveness, and quality standards and productively participates in continuous quality improvement efforts to streamline workflows, so as to maximize effectiveness and efficiency. * Ensures compliance with state, federal, and accreditation regulatory requirements. * Achieves and maintains
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