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Intake Coordinator
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- This job captures all inbound requests for utilization review from providers and pharmacies.
- The incumbent assesses the request, conducts all necessary research such as verifying benefit coverage for the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review.
- Ensures all accurate information is entered at the onset of the process to ensure adherence to all regulatory compliance requirements and service level agreements.
- Build cases in the utilization management system.
- Use knowledge of process and judgement to evaluate identified cases that require additional notification to member, provider, and/or pharmacist.
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