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Claim Intake Representative Jobs in Texas (NOW HIRING)

Elementia

Warranty Claims Specialist

Houston, TX · On-site

$50K - $58K/yr

... from initial intake through resolution. The position reviews claim documentation, evaluates ... representatives, and internal stakeholders throughout the claim process. Maintain accurate and ...

Upbound

Corporate Counsel

Plano, TX

... FAQs, intake requests, and other recurring legal processes. Compliance and Risk Mitigation ... support representation at arbitration hearings before the AAA, as needed. * Support claim ...

Upbound Group Inc.

Corporate Counsel

Plano, TX · On-site

... FAQs, intake requests, and other recurring legal processes. Compliance and Risk Mitigation ... support representation at arbitration hearings before the AAA, as needed. * Support claim ...

Upbound

Counsel, Legal

Plano, TX

... FAQs, intake requests, and other recurring legal processes. Compliance and Risk Mitigation ... support representation at arbitration hearings before the AAA, as needed. * Support claim ...

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Showing results 21-40

All JobsClaim Intake Representative JobsClaim Intake Representative Jobs in Texas

Claim Intake Representative information

What is a claim intake representative?

Claim Intake Representatives are professionals responsible for receiving, reviewing, and processing initial insurance claim information from policyholders, claimants, or providers. They gather and verify necessary details, enter data into claim management systems, and ensure that claims are forwarded to the appropriate departments for further handling. Their role requires excellent communication and data entry skills, as well as a strong understanding of company policies and customer service practices. Claim Intake Representatives may work in various sectors, such as health, auto, or property insurance.

What are the key challenges a claim intake representative typically faces during the claims process?

A Claim Intake Representative often encounters challenges such as managing high call volumes, accurately gathering detailed information from sometimes distressed clients, and ensuring all data is correctly entered into claims systems. Balancing efficiency with empathy is crucial, as representatives must provide excellent customer service while adhering to strict compliance guidelines. Additionally, they must effectively collaborate with claims adjusters, supervisors, and other departments to facilitate smooth case handoffs and timely resolution.

What are the key skills and qualifications needed to thrive as a claim intake representative, and why are they important?

To thrive as a Claim Intake Representative, you need strong attention to detail, data entry accuracy, and a solid understanding of insurance terminology, often supported by a high school diploma or equivalent. Familiarity with claims management systems, customer relationship management (CRM) software, and proficiency in Microsoft Office are typically required. Excellent communication, active listening, and problem-solving skills help individuals excel when interacting with claimants and internal teams. These skills ensure claims are processed efficiently, accurately, and with a positive customer experience, which are critical for organizational success.

What is the difference between Claim Intake Representative vs Claims Processor?

Claim Intake RepresentativeClaims Processor
Handles initial claim submissions, verifies information, and gathers necessary documentation.Reviews, evaluates, and processes claims after initial intake, often making determinations on claim validity.

While both roles are essential in the insurance claims process, Claim Intake Representatives focus on the initial contact and data collection, whereas Claims Processors handle the detailed review and decision-making. Both positions require similar credentials and work in the same industry environment, often within insurance companies or third-party claims organizations.

Insurance Verification Specialist-Remote-Frisco,TX

Dallas, TX • On-site, Remote

Soleo Health Inc
Health Care and Social Assistance • 1 - 5K employees
Learn more about Soleo Health Incexternal

$23 - $27/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 10 days ago

Job description

Description:

Soleo Health is seeking a Clearance Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!  


Specialty infusion experience and ability to work 8:30a-5pm central time zone required.

Soleo Health Perks:

  • Competitive Wages  
  • 401(k) with a Match 
  • Referral Bonus    
  • Paid Time Off 
  • Great Company Culture  
  • Annual Merit Based Increases 
  • No Weekends or Holidays   
  • Paid Parental Leave Options 
  • Affordable Medical, Dental, & Vision Insurance Plans 
  • Company Paid Disability & Basic Life Insurance 
  • HSA & FSA (including dependent care) Options 
  • Education Assistance Program   

This Position:

The Clearance Specialist is responsible for processing new referrals including but not limited to verifying patient eligibility, test claim adjudication, coordination of benefits, and identifying patient estimated out of pocket costs. They will also be responsible for preparation, submission, and follow up of payer authorization requests. Responsibilities include:

  • Perform benefit verification of all patient insurance plans including documenting coverage of medications, administration supplies, and related infusion services
  • Responsible to document all information related to coinsurance, copay, deductibles, authorization requirements, etc
  • Calculate estimated patient financial responsibility based off benefit verification and payer contracts and/or company self-pay pricing
  • Initiate, follow-up, and secure prior authorization, pre-determination, or medical review including reviewing and obtaining clinical documents for submission purposes
  • Communicate with patients, referral sources, other departments, and any other external and internal customers regarding status of referral, coverage and/or other updates as needed 
  • Refer or assist with enrollment any patients who express financial necessity to manufacturer copay assistance programs and/or foundations
  • Generate new patient start of care paperwork 
  • Other duties as assigned

Schedule:

  • Monday-Friday,  8:30a-5pm central time zone 
Requirements:
  • At least 2 years of home infusion specialty pharmacy intake experience required
  • High school diploma or equivalent
  • Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines including ability to interpret payor contract fee schedules based on NDC and HCPCS units 
  • Strong ability to multi-task and support numerous referrals/priorities while ensuring productivity expectations and quality are met
  • Ability to work in a fast-paced environment
  • Knowledge of HIPAA regulations
  • Basic level skill in Microsoft Excel & Word
  • Knowledge of CPR+ preferred

About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference! 


Soleo’s Core Values:

  • Improve patients’ lives every day
  • Be passionate in everything you do
  • Encourage unlimited ideas and creative thinking
  • Make decisions as if you own the company
  • Do the right thing
  • Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.  

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Keywords: Prior Auth, Insurance, Referrals, Now hiring, hiring now, immediately hiring, hiring immediately, insurance coordinator, intake representative, prior authorization coordinator