POSITION OVERVIEW:

The Intake Services Specialist efficiently handles the preparation, intake, and administrative processing of all inquiries. That includes the daily coordination of receiving all incoming inquiries (via fax, email, mail), faxing out specified response letters, responding to emails and submitting client requests.

KEY RESPONSIBILITIES:

• Responsible for coordination and intake of all incoming inquiries (via Fax, Mail, Email, etc.) by logging inquiry into OnBase (in-house system).

• Perform claim look up's and identify claims associated with incoming inquiries.

• Extracting multiple inquiries; separating and organizing accordingly and attaching to their appropriate claim.

• Review certain incoming inquiries based on specified criteria, either sending a template letter response out or determining the inquiry needs to be forwarded for further review to a coding analyst.

• Send correspondence to providers as needed regarding our inquiry submission process and contact information.

• Review, resolve and complete all Inquiries assigned to queues in which a review by a coding analyst is not required: (ETF, Non-Accepted, Attachment Missing, Corrected Claims, and other projects as assigned).

• Entering requests to clients as needed for additional information, following up on those requests in a timely manner and providing resolution to the claim.

• Aiding in preparation of a claim for adjustments as necessary.

• Assigned duties based on client needs.

• Performs other related responsibilities as assigned/needed.

• Maintain awareness of and ensure adherence to ZELIS standards regarding privacy.

COMPETENCIES:

• Computer proficiency and technical aptitude with the ability to utilize CMS and MS Office Applications, Adobe Application (PDF) - Extracting pages and attaching inquiry

• Works on assignments that are minimally complex in nature in which judgment and initiative are required to make recommendations or resolve problems

• Thorough knowledge of the company and departmental policies and procedures

• Knowledge of MS Outlook, MS Word, MS Excel & Internet Explorer

• Strong prioritizing & organizational skills for fast-paced department

EDUCATION:

• 1+ years healthcare and medical claims processing experience within a provider/facility's office or Payer

• Ability to manage and prioritize multiple tasks

• Ability to work under pressure and meet deadlines

• Ability to follow detailed instructions on assignments

• Must have a professional manner and respect the confidentiality of all pertinent information while performing tasks

• Must work well with others.

• Effectively communicates with others by giving and receiving feedback

WORK ENVIRONMENT:

• Possesses detail-orientation as well as strong written and oral communication skills.

• Demonstrates self-motivation and the ability to work independently and as a team.

• Demonstrates ability to handle, balance and prioritize workload from various service units and individuals in a fast-paced environment.

• Ability to deal with problems involving a few concrete variables in standardized situations.

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#LI-Hybrid

As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

Commitment to Diversity, Equity, Inclusion, and Belonging 
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity  
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. 

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.  

Accessibility Support 

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email [email protected]   

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