Intake Solutions Specialist

A company is looking for an Intake Solutions Specialist who supports clinical, technical, and provider teams by processing prior authorization requests for medical and pharmacy services.

Key Responsibilities

Receive and process incoming prior authorization requests through various channels

Verify member eligibility and benefit coverage, ensuring compliance with guidelines

Monitor and track cases to maintain compliance with turnaround standards and assist in quality improvement activities

Required Qualifications

Associate's degree or healthcare administration coursework preferred; high school diploma with experience considered

2-5 years of experience in a healthcare, insurance, or utilization management environment

Knowledge of medical terminology and healthcare coding (ICD-10, CPT, HCPCS)

Understanding of prior authorization and medical necessity processes

Experience with UM or care management platforms and electronic prior authorization portals