Intake Specialist

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Accurately receive and log all incoming referrals through phone, fax, email, and referral portals in the intake tracking system in real time.

• Perform initial eligibility screenings to confirm insurance coverage, benefit levels, and ABA service authorization requirements.

• Collect and organize all necessary intake documentation from families and referring providers, including diagnostic evaluations, prescription letters, and consent forms.

• Promptly and professionally communicate the receipt of referrals and next-step instructions to families.

• Escalate complex or high-priority referrals to the Lead Intake Specialist as necessary.

• Assist in preparing and submitting prior authorization requests for ABA services to Medicaid, managed care organizations, and commercial insurance payers.

• Follow up on pending authorization submissions and record status updates in the tracking system.

• Collaborate with clinical staff (BCBAs / LBAs) to gather required clinical documentation in support of authorization requests.

• Identify cases that may require Single Case Agreement (SCA) processing and refer them to the Lead Intake Specialist or SCA Specialist.

• Monitor upcoming authorization expiration dates and initiate re-authorization outreach under the guidance of the Lead Intake Specialist.

• Contact families promptly upon referral receipt to explain the intake process, gather necessary information, and address general inquiries.

• Maintain empathetic and professional communication throughout the enrollment process, understanding that families often navigate a complex and unfamiliar system.

• Respond to inbound inquiries from families, pediatricians, schools, and other referral sources concerning intake status, required documents, and next steps.

• Keep families informed of any delays, documentation gaps, or payer-related requirements that may impact their enrollment timeline.

• Maintain accurate, complete, and current records for all referrals and active intake cases in the designated tracking system.

• Ensure that all intake files comply with documentation standards required by payers and regulatory bodies.

• Conduct routine audits of assigned intake cases to identify missing documents, outstanding items, or stalled pipeline stages.

• Generate status reports on assigned caseload as requested by the Lead Intake Specialist or Director of Operations.

• Collaborate with billing, clinical, and scheduling teams to facilitate a seamless transition from intake authorization to active service delivery.

• Participate in intake team huddles, pipeline reviews, and cross-departmental coordination meetings as directed.

• Assist the Lead Intake Specialist with special intake projects, payer-specific workflows, or capacity-driven assignments as needed.

• Comply with all HIPAA regulations and confidentiality policies when handling client records and communications.

⛳️ Requirements

• High school diploma or equivalent required; an Associate's or Bachelor's degree in Healthcare Administration, Human Services, Business, or a related field is preferred.

• A minimum of 1–2 years of experience in healthcare intake, patient access, insurance coordination, or an administrative support role.

• Knowledge of health insurance terminology, including prior authorizations, eligibility verification, EOBs, and Medicaid managed care.

• Strong organizational skills with the ability to manage multiple active cases simultaneously without compromising accuracy.

• Excellent written and verbal communication skills, with a proven ability to communicate sensitively with families navigating healthcare systems.

• Proficiency in Microsoft Office Suite and/or Google Workspace; ability to quickly learn new intake and tracking systems.

• Strict adherence to HIPAA regulations and confidentiality standards in all aspects of the role.

• **Preferred**

• Experience in an ABA therapy, behavioral health, or pediatric healthcare intake or patient access environment.

• Familiarity with New York State Medicaid managed care plans, commercial payer prior authorization portals, and ABA-specific authorization requirements.

• Bilingual in English and Spanish — strongly preferred.

• Experience using electronic health record (EHR) systems, CRM platforms, or intake management software.

• Demonstrated ability to work within structured, process-driven environments with defined performance metrics and turnaround standards.

🏝️ Benefits

• Join Our Dynamic Team: Experience our fun, inclusive, innovative culture that values your unique contributions and supports your professional growth.

• Embrace the Opportunities: Seize daily chances to learn, innovate, and excel. Make a real impact in your field.

• Limitless Career Growth: Unlock a world of possibilities and resources to propel your career forward.

• Fast-Paced Thrills: Thrive in a high-energy, engaging atmosphere. Embrace challenges and reap stimulating rewards.

• Flexibility, Your Way: Embrace the freedom to work from home or any location of your choice. Create your ideal work environment.

• Work-Life Balance at Its Best: Say goodbye to stressful commutes and hello to quality time with loved ones. Achieve a healthy work-life integration to perform at your best.