Job Description Principal Accountability: • Screens information received and refers members to the appropriate provider and/or contacts the provider directly for members. • Facilitates the authorization process for requests that do not require clinical criteria application or judgment. • Provides relevant information to members and assists them in resolving Plan related problems when Member Services personnel are not available. • Acts as a resource to staff for questions related to the prior authorization process. • Refers unresolved prior authorization process questions to the Lead Intake Specialist. • Assists the Lead Intake Specialist in identifying, planning and implementing staff training programs. • Identifies and reports member and provider educational opportunities to the Lead Intake Specialist. • Accurately answers questions regarding Plan benefits and Utilization Management requirements for members and providers. • Makes appropriate inquiries to determine potential coordination of benefits and advises appropriate provider and claims staff of same. • Supports Utilization Management nurses with data entry. • Performs other duties as assigned. • Adheres to Select Health and KMHP policies and procedures. • Supports and carries out the Select Health and Mercy Mission & Values. Key Competencies/Success Factors: • Excellent interpersonal and verbal communication skills. • Attention to detail and confidentiality. • Patience and a balanced demeanor. • Professional image. • Ability to write clear and concise reports. • Willingness to work any shift. • Availability for in-service training. Requirements/Certifications: REQUIREMENTS: • High School Diploma / GED • Proficient PC Skills in a Windows based environment including word processing, spread sheets and working in database programs. • Proven ability to keep accurate and timely records and documentation according to established processes • Experience as a medical assistant or role with similar responsibilities • Experience handling multiple calls or triaging calls • Medical Terminology, ICD, CPT, and coding experience Additional Information All your information will be kept confidential according to EEO guidelines.