Intake Coordinator

This is a Fully Remote Job
About Our Client:
Guidehealth operates in the healthcare industry, focusing on improving healthcare affordability, patient health outcomes, and provider satisfaction. The organization uses data analytics, artificial intelligence, and a centralized managed service model to connect patients and providers effectively. It emphasizes value-based care and supports providers in delivering high-quality healthcare both within and beyond clinical settings.
About the Opportunity:
The INTAKE COORDINATOR is responsible for reviewing and approving routine referrals and pre-certifications for a Blue Cross HMO program. This role supports clinical services by managing referral screenings, ensuring compliance with protocols, and facilitating communication between providers, clinical staff, and claims personnel. The position contributes to the organization's operational efficiency and the smooth authorization of healthcare services.
Responsibilities:
Review and approve routine referrals and pre-certifications following established guidelines
Conduct pre-review screenings on complex referrals and escalate as needed
Provide clerical support including data entry and phone communication
Enter referral and pre-certification data accurately using ICD-10 and CPT coding
Maintain confidentiality of healthcare information
Assist providers with referral and pre-certification inquiries
Collaborate with provider relations and claims staff to resolve discrepancies
Support clinical services in maintaining internal referral manuals
Adhere to audit procedures
Perform additional duties as assigned
Requirements:
Prior experience in a healthcare setting
Strong knowledge of HMO structures
Basic proficiency with Excel and PDF or Adobe Pro
Organizational and task-oriented skills
Strong time management abilities
Ability to work independently
Preferred: understanding of medical coding (CPT and ICD-9) and relevant advanced degrees or certifications
Pay Range and Compensation Package:
$20 - $21 per hour based on skills and experience
Benefits & Perks:
Remote work flexibility
Comprehensive medical, dental, and vision insurance
401(k) plan with 3% employer match
Life and disability insurance with voluntary life options
Employee Assistance Program
Paid time off
Paid parental leave
Professional development resources
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.

Work arrangement
Yes