Intake Specialist

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 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. Essential Qualifications The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: High School or GED Equivalent Preferred Education, License/Certification, or Work Experience: Certificate from college or technical school or 3-6 months experience and/or training Expectations and Standards Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. Promote Avera’s values of compassion, hospitality, and stewardship. Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. Maintain confidentiality. Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. PTO available day 1 for eligible hires. Up to 5% employer matching contribution for retirement Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org .