Claims Intake Jobs Near Me

Description

Position Summary

We are seeking an Intake Manager to own end-to-end intake operations for assigned program(s) within Patient Care / Intake Operations, ensuring alignment with organizational goals, operational excellence, and compliance standards. Reporting to the Director of Operations and Process Automation, the Intake Manager is the accountable owner for their program's intake journey - from initial prescription receipt through compliant prescription processing up to the stage of dispensing - while building the people and processes that make it scale.

Key Responsibilities

• Program Ownership & Implementation: Own the intake operations strategy for assigned program(s) from initial implementation through ongoing optimization; lead program launches, including intake setup, workflow configuration, and cross-functional readiness coordination.
• Workflow Design & Process Improvement: Design, document, and maintain intake workflows for assigned program(s), ensuring clarity, efficiency, and compliance; identify bottlenecks and implement process improvements that reduce errors and improve throughput.
• Training & Team Development: Develop and deliver training programs for Intake Specialists assigned to your program(s); onboard new team members with a structured, program-specific training plan; build and maintain reference materials, SOPs, and job aids to support consistent team performance.
• Intake Specialist Performance Monitoring: Monitor daily workflow execution, productivity, and quality metrics for Intake Specialists; provide regular feedback, coaching, and performance support; escalate systemic performance or training issues to the Director of Operations and Process Automation with clear recommendations.
• Intake Operations: Ensure timely, accurate processing of incoming prescriptions; oversee billing workflows and prescription accuracy; serve as subject matter expert for intake and billing requirements specific to assigned program(s); troubleshoot escalated intake issues and implement durable process fixes.
• Patient & Provider Communication: Manage escalated communication with patients and providers to resolve prescription discrepancies or urgent intake issues; partner with Customer Success to ensure smooth handoffs and consistent communication across teams.
• Compliance & Documentation: Ensure all intake activity adheres to HIPAA and applicable regulatory requirements; maintain accurate, audit-ready documentation for program workflows and team performance; ensure compliance with Ohio controlled medication laws and any program-specific regulatory requirements.

Qualifications

• Education: Bachelor's degree or equivalent combination of education and experience.
• Licensure/Certification: Active Certified Pharmacy Technician (CPhT) license in Ohio, in good standing. Required.
• Experience: 3-5 years as a Certified Pharmacy Technician with direct intake or dispensing experience; 3-5 years in a team lead, supervisor, or operations management role, preferably in pharmacy or healthcare operations.
• Skills:
  • Working knowledge of Federal and Ohio controlled medication laws and HIPAA requirements.
  • Working knowledge of insurance billing processes as they apply to pharmacy claims adjudication.
  • Understanding of the prior authorization cycle, including initiation, submission, follow-up, and appeals.
  • Proven ability to lead teams and drive performance, with a coach's instinct for building team capability over time.
  • Strong understanding of pharmacy management systems, intake workflow tools, and cross-functional operational environments.
  • Experience in pharmacy intake, billing, or operations for complex medication programs preferred, including prior involvement in launching or scaling a new pharmacy program or service line.

Desired Attributes

• Systems thinking: Ability to design workflows and spot failure points before they become problems.
• People development: A coach's instinct for building team capability over time.
• Operational rigor: High attention to detail with a drive toward measurable quality standards.
• Adaptability: Comfortable operating in a fast-paced, evolving environment.
• Cross-functional communication: Able to collaborate clearly with pharmacists, automation teams, and operational leadership.
• Accountability: Takes ownership of program outcomes and escalates with context and solutions.

Work Environment

• Location: Columbus, OH (On-site)
• Schedule: Full-time; standard business hours
• May require availability during program go-live events or escalated intake situations outside standard business hours.
• Regular cross-functional meetings with QA Leads, pharmacy operations, automation teams, Customer Success, and Operations leadership.

Key Essential Functions

• Ability to sit and work at a computer for up to 8 hours.
• Perform repetitive typing motions with accuracy.
• Navigate multiple systems simultaneously.
• Maintain focus and quality standards under high workload; meet program-level productivity and quality benchmarks.

Employment Classification

Status: ? Full-time ? Part-time ? Temporary
FLSA: ? Exempt ? Non-Exempt  

Equal Employment Opportunity (EEO) Statement

Gifthealth is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. All employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, transgender status, national origin, age, disability, veteran status, or any other legally protected status.

Disclaimer

This job description is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of all responsibilities, duties, or skills required of personnel.Gifthealth reserves the right to modify job duties or descriptions at any time.