Intake Specialist

Summary

The Intake Specialist contributes to IHC's mission and goals of client satisfaction, quality of care, cost competitiveness and productivity by ensuring efficient handling of all client income documentation, front-office paperwork, EMRs, and billing. The Intake Specialist works closely with the other front office staff to provide customer service to clients in the lobby and on the phone, and complete billing paperwork and daily reports integral to monitoring the overall effectiveness of the clinic.

A certified Intake Specialist acts as a navigator and has advanced knowledge of how to navigate the entire clinic process flow. They apply this knowledge to determine the eligibility for the various Medicaid, Medicare, sliding fee scales and payment plans.

Evaluation of performance

Performance will be evaluated based on meeting specific goals, productivity measures, employee satisfaction scores, and other quality indicators for this position such as: IHC strategic objectives; site strategic objectives; functional capabilities; leadership and/or employee capabilities; IHC commitments, quality measures, and productivity measures.

Application of knowledge

Certified Intake Specialist requires expert knowledge of a wide body of income eligibility rules in addition to verification, application, and documentation procedures and requirements. Requires specialized knowledge of various Medicaid and Medicare application processes, medical billing practices, electronic medical records, and IHC's policies and procedures. Intake Specialist requires general knowledge of work common to eligibility, billing, payment, and reception, including knowledge of IHC's guidelines, practices, standard terminology, and methods to support the intake function.

Clerical:

• Greets clients and visitors to clinic and assists with check in process.
• Makes appointments and educates clients regarding documents they will need to provide at the time of service.
• Answers phones and accurately direct calls.
• Accurately enters, maintains, and retrieves data on IHC's computer system.
• Uses and maintains electronic medical record, accurately assembles income documents, and ensures client information is up to date and complete.

Medical Billing:

• Assists in timely completion of daily Batches, including migrant worker Batches, ensuring all information is complete and accurate on the superbill and that all supporting documents are attached.
• Assists in running daily Variance Report.
• Determines eligibility and signs up eligible clients for Medicaid or Medicare part D, refers eligible clients to WIC programs.
• Certified - troubleshoots patients billing and payment questions/issues.
• Certified - drafts payment plans for office/practice manager review and approval.

Job controls and complexity

The Intake Specialist operates using established sequential steps and guidelines including those established by Medicaid, as well as other operating instructions and procedure manuals. Tasks involve related steps, processes and methods that require the Intake Specialist to recognize clear differences in a variety of situations. Work affects accuracy, reliability, or acceptability of further processes and services. This affects the client's ability to receive services and the clinic's ability to receive payment for services rendered.

Nature and purpose of contacts

Contacts are primarily routine and structured, typically involving clients, state agencies, professional and non-professional staff and visitors. Contacts are to coordinate work, advise on collaborative work, and solve recurring types of problems in situations where others are usually cooperative.

Critical skills and behaviors

Logic and Analysis - Able to:

• Think logically and analytically.
• Demonstrate proficiency in basic mathematics.

Communication - Able to:

• Demonstrates effective verbal and written communication skills.
• Interact with a diverse population with a wide range of educational levels including children.
• Maintain effective working relationships with physicians, other employees, and patients.
• Demonstrate positive customer service skills.
• Resolve conflicts, think creatively, and negotiate solutions.
• Demonstrate positive customer service skills in person and over the phone.
• Work well in a team environment and as part of a team.

Intake Functions: Able to:

• Learn and follow standard work practices/procedures - every time - without variation or error.
• Follow established routines, requiring occasional modifications in procedure.
• Train others on intake functions and standard work
• Demonstrate proficiency in patient scheduling, including procedures for walk-ins, overbooking, and rescheduling.
• Demonstrate proficient knowledge about Medicaid and Medicare requirements.
• Counsel clients on the advantages and services provided by Medicaid.
• Recognize, troubleshoot, and/or alert others to potential scheduling conflicts or problems.
• Take initiative; prioritize, organize tasks and time; follow up.

Work Product: Able to:

• Demonstrate high detail orientation and accuracy.
• Perform responsibilities accurately, efficiently, and timely.
• Demonstrate knowledge of standard office practices and procedures.
• Able to juggle multiple requests and meet multiple deadlines.

Process Improvement - Able to:

• Follow standard work procedures.
• Participate in process improvement projects as required.
• Participate in high performing work teams; maintain a team approach to problem solving.

Physical demands and work environment

• Majority of work is non-strenuous.
• Some, albeit limited, potential risk from disgruntled or disoriented patients, and/or clinic environment.
• Must be able to operate general office equipment, including computers, telephone, etc.