Medical Management Intake Specialist

Our client, a Health Insurance company, is looking for a Medical Management Intake Specialist for their Detroit, MI/Hybrid location.
 
Responsibilities:

• The original scope for bring specialist onboard is to work on PIAI projects provider data clean up measures. 
• Upon completion of projects, we are finding that these projects are turning into ongoing processes.
• Validating provider information through auditing processes to reduce and eliminate inaccurate data for accuracy and auditing purposes.
• Increase provider accuracy on members website by eliminating outdated information.
• Perform several outreaches daily to providers across Michigan to verify certainty of demographic information such as phone numbers, address, accepting new patients.
• Review and process results of audits for validity in collaboration with leadership to ensure accurate data is uploaded into database.

• High school dipolma
• 3 to 5 years experience
• For example:
• State of Michigan BH (SOM BH) Audit provider outreach, Provider Data Confidence Value (PDCV) audit provider outreach, return mail, facility attestation noncompliant providers, daily CAQH Directory Verification task.
• The rest of the required skills/experience:
• Excel
• Access
• Outlook
• Preferred Skills/Experience:
• Optional but preferred skills/experience:
• Include:
• Portico
• SF Macess
• Facets

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities