Bilingual Intake Coordinator

: Description:

Valenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity, and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan, and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality, and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare.

About Our Opportunity

As a Bilingual Intake Coordinator (aka: Utilization Management Intake Coordinator), you will receive inbound calls, faxes, and web requests from providers and/or clients. You will initiate and facilitate the authorization process in accordance with established health plan policies and procedures.

Things You'll Do Here:

• Document demographic information obtained from telephonic, fax, or emailed requests within the care management system.
• Make outbound calls to follow up on discharge information or request updated clinical information as necessary for concurrent review.
• Screen inquiries to determine the services that require certification at the time of the inquiry
• Obtain clinical information and forward the caller to the clinical staff for completion of the review.
• Provide certification based upon scripted clinical algorithms or benchmark Length of Stay.
• Collaborate and effectively communicate with internal and external partners.
• Stay up to date on Summary Plan Documents and other related resources related to service requests.
• Ensure applicable URAC standards, Confidentiality/HIPAA standards, and internal policies, practices, and productivity metrics are met.
• Performs other related duties as assigned by supervisor.

Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

Where You'll Work

This role is remote.

Why You Will Love Working Here

We offer employee perks that go beyond standard benefits and compensation packages - see below!

At Valenz, our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare . We want everyone engaged within our ecosystem to be strong, vigorous, and healthy. You'll find limitless growth opportunities as we grow together. If you're ready to utilize your skills and passion to make a significant impact in the healthcare self-funded space, Valenz might be the perfect place for you!

Perks and Benefits

• Generously subsidized company-sponsored medical, dental, and vision insurance
• Company-funded HRA
• 401K with company match and immediate vesting
• Flexible working environment
• Responsible Paid Time Off
• Paid maternity and paternity leave
• Paid company holidays
• Community giveback opportunities, including paid time off for philanthropic endeavors

At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

Requirements:

What You'll Bring to the Team:

• 2+ years of experience in high-volume call center or customer support environment.
• High attention to detail while maintaining courteous, accurate, and timely relations with our partners and members.
• Strong problem solving skills.
• Excellent communication skills, both verbal and written.
• GED or High School Diploma.
• Fluent in reading, writing, and speaking Spanish and English.

A plus if you have :

• Medical, claims, or collection call center experience.
• Medical Terminology Certification.
• Microsoft Office Suite experience.