Trustmark’s mission is to improve wellbeing – for everyone. It is a mission grounded in a belief in equality and born from our caring culture. It is a culture we can only realize by building trust. Trust established by ensuring associates feel respected, valued, and heard. At Trustmark, you’ll work collaboratively to transform lives and help people, communities and businesses thrive. Flourish in a culture of diversity and inclusion where appreciation, mutual respect and trust are constants, not just for our customers but for ourselves. At Trustmark, we have a commitment to welcoming people, no matter their background, identity, or experience, to a workplace where they feel safe being their whole, authentic selves. A workplace made up of diverse, empowered individuals that allows ideas to thrive and enables us to bring the best to our colleagues, clients, and communities.

Trustmark Health Benefits is currently seeking an Intake Coordinator with a passion for exceptional service to work Monday through Friday, 10:00 am to 6:00 pm EST. The Intake Coordinator is responsible for providing quality service by accurately and respectfully triaging telephone, written and electronic inquiries from employees/members, providers and clients. Inquiries include a variety of topics such as pre-certification requests, benefit verification, status requests, etc. The HCM Operations Intake Coordinators service business for Health Benefits, Small Business Benefits, and key clients.

Responsibilities:

• Respond to incoming Healthcare Management calls and faxes to determine the reason for the call. Make determinations on precertification requirements, continues stay review, discharge planning, case management referrals, etc. using system notes and department guideline manuals and triages the call or fax appropriately.
• Responsible for reviewing faxes and confirming all clinical criteria is present to submit to the Utilization Management Team to complete a review.
• Ability to advise status of a request that meets the criteria of an auto approval based on standard clinical criteria sets.
• Advises callers of the Utilization Management certification requirements based on client information located on the HCM Group Matrix and within TruCare.
• Offers to connect callers to the benefit department for clarification of plan benefits
• Collects all pertinent demographic information as it relates to the certification of inpatient, outpatient, and alternative site care and enters into the HealthCare Management Information system, documenting per departmental procedures. Accurately collects Diagnosis Codes, CPT, HCPS codes and understands how to categorize the service based on those codes.
• Initiates outbound calls to request clinical information and discharge dates.
• Assist on help desk answering questions that the intake team has regarding a call that they are on.
• Completes voicemail transcription from the queue and returns calls for confirmation of data and initiation of the certification processes as appropriate.
• Completes administrative lack of information process for non-receipt of clinical information.
• Responsible for verifying charges-to-date on an individual case and providing appropriate notification and/or referral per current guidelines
• Participates in quality improvement initiatives such as verifying clinical is received appropriately for reviews of the auto approval process.
• Retrieves data from vendor portals and inputs information into TruCare to initiate a utilization review and/or case management referral when appropriate.
• Enrolls members into referral programs when applicable.
• Triages inquiries sent to the HCM department via the claims inquiry or cert request queues.
• Acts as a liaison to the privacy office for our PAR process.
• Completes URAC assessments and training to ensure full understanding of URAC processes to assist in reaccreditation if selected.
• Assists in the administrative preparation and filing of physician review referrals to contracted sub-vendors.
• Testing of rules added to the BRE tables and assists with upgrade testing.
• Assist providers in navigating into ProAuth and trouble shoot basic questions and issues. Work tasks related to corrupt files submitted into proAuth.
• Prioritize daily work assignment to meet division goals and customer requirements.
• Collaborate as necessary with internal and external customers to achieve excellent service results.
• Other duties and special projects as needed/assigned by HCM Management.

Requirements:

• Strong oral and written communication skills required;
• Ability to read and interpret documents, criteria, instructions and policy & procedure manuals;
• Speak effectively with clients, physicians, providers, families in crisis and community agencies as well as co-workers and senior management;
• Add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals and ability to compute rate, ratio and percentage;
• Evaluate problems, develop alternative solutions and identify trends and patterns;
• Capable of working in an environment that requires organization and prioritization in order to address time sensitive assignments;
• Maintain high level of confidentiality, flexibility and willingness to learn new tasks;
• Previous experience in a healthcare or insurance environment a plus.
• Previous experience either working in a call center or handling calls preferred.
• Medical terminology, medical coding, or ICD-9 experience preferred.
• Demonstrated computer proficiency in Microsoft Suite (Word, Excel, Outlook)
• Ability to work in a detailed and fast-paced call center environment, consistently delivering exceptional customer service
• Ability to work from a home office that is equipped with high-speed internet.
• Ability to work Monday through Friday 10:00 am – 6:00 pm ET required.

Come join Trustmark! Join a team that will not only utilize your current skills but will enhance them as well. Trustmark benefits include health/dental/vision, life insurance, FSA and HSA, 401(k) plan, Employee Assistant Program, Back-up Care for Children, Adults and Elders and many health and wellness initiatives. We also offer a Wellness program that enables employees to participate in health initiatives to reduce their insurance premiums.

For the second consecutive year we were selected as a Top Workplace by the Chicago Tribune. The award is based exclusively on Trustmark associate responses to an anonymous survey. The survey measured 15 key drivers of engaged cultures that are critical to the success of an organization.

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, sexual identity, age, or disability.