Intake Specialist

About the Role

The day-to-day responsibilities of this role involve reviewing requests, verifying member benefits and eligibility, and maintaining accurate records. You will also be responsible for triaging and assigning incoming inquiries to the appropriate staff in a timely and efficient manner. Your analytical skills will be essential in identifying patterns, trends, and areas for improvement, which will inform feedback to Team Leads on employee development needs.

Blue Cross NC values its employees and offers a supportive team environment. As an Intake Specialist, you will be part of a dynamic team that is committed to delivering exceptional service to its members and providers. Your contributions will have a direct impact on the quality of service provided, and your ideas and suggestions will be valued and encouraged.

What You Will Do

• Process a variety of internal and external member and provider requests and transactions via phone, email, fax, and mail
• Review requests to ensure accuracy and completeness
• Enter data into the system, attaching supporting information as applicable
• Document all pertinent information related to the call or inquiry
• Gather and analyze data to provide feedback to Team Leads on employee development needs
• Screen inquiries to determine if authorization is required
• Verify member benefits and eligibility and/or provider setup
• Maintain and update Service Requests and research incorrect or missing information
• Triage and assign all incoming inquiries in a timely and efficient manner
• Provide clinical review outcome notification to members and providers (verbal and written)
• Collaborate with internal stakeholders to resolve complex issues
• Participate in special projects as needed

What We Are Looking For

• High school diploma or GED required
• 3+ years of experience in a related field, preferably in a healthcare or customer service setting
• Excellent verbal and written communication skills
• Strong analytical and problem-solving skills
• Ability to work in a fast-paced environment and prioritize tasks effectively
• Experience with data entry and data analysis
• Proficiency in Excel and other Microsoft Office applications
• Ability to maintain confidentiality and handle sensitive information
• Strong organizational and time management skills

Nice to Have

• Prior experience in a call center or customer service environment
• Knowledge of healthcare insurance industry and medical terminology
• Experience with electronic health records (EHRs) and claim processing systems
• Certification in a related field, such as medical billing or coding

Benefits and Perks

• Competitive salary range
• Annual Incentive Bonus based on corporate goal achievement and individual performance
• 401(k) with employer match
• Paid Time Off (PTO) and holidays
• Comprehensive health benefits, including medical, dental, and vision coverage
• Wellness programs and employee assistance programs
• Remote work options and flexible scheduling
• Opportunities for professional development and growth
• Recognition and reward programs for outstanding performance

• Develop a strong understanding of Excel and data analysis to stand out in this role.
• Highlight your problem-solving skills and experience in data analysis in your application and during interviews.
• Be prepared to provide examples of times when you had to prioritize tasks effectively in a fast-paced environment.
• Showcase your excellent communication skills by providing clear and concise responses to questions.
• Research Blue Cross NC's values and mission to demonstrate your enthusiasm for the company and the role.
• Be prepared to discuss your experience with data entry and data analysis, and how you can apply these skills to this position.
• Consider creating a portfolio or examples of your work to demonstrate your skills and experience.