Intake Coordinator (Healthcare)

TL;DR

Intake Coordinator (Healthcare): Processing inbound utilization management requests from providers and pharmacies with an accent on benefit verification and case creation. Focus on ensuring data accuracy for clinical review and adhering to regulatory compliance and SLAs.

Location: Remote or office-based in Pennsylvania, USA

Company

hirify.global is a leading healthcare organization providing comprehensive health insurance and clinical services.

What you will do

• Process inbound inquiries via fax, provider portals, and phone from pharmacies and healthcare providers.
• Verify member benefit eligibility and gather all required supporting documentation.
• Create and build cases within the utilization management system for clinical review.
• Conduct outreach to providers and pharmacists to obtain missing or additional information.
• Maintain high data entry accuracy to prevent compliance issues and downstream process delays.

Requirements

• Must be based in Pennsylvania.
• 1 year of experience in Customer Service.
• 1 year of experience in the Healthcare industry.
• High School Diploma or GED.
• Ability to navigate multiple software systems simultaneously.
• Strong written and oral telephonic communication skills.

Culture & Benefits

• Flexible work arrangements with options for office-based or remote work (Work at Home).
• Structured professional environment adhering to high ethical and legal standards.
• Commitment to diversity, equity, and inclusion in the workplace.