Position Purpose: Manage all activities related to the intake, referral management and insurance verification functions, including implementation of initiatives.
Key Details: Experience in major medical insurance verification preferred. Knowledge of Intravenous Immunoglobulin, Home Infusion and IV Drug Management preferred. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
- Develop indicators for monitoring and evaluating quality of work and meeting turnaround time standards
- Establish work directions, resolve problems, and set performance expectations and deadlines to ensure timely completion of all department deliverables
- Evaluate current procedures and practices and implement changes ensuring compliance with all related laws, regulations and contractual requirements
- Ensure all deadlines related to referral processing and turnaround times for the assigned programs are met
- Ensure up to date quality control processes to ensure integrity of enrollment and insurance verification data
- Develop and ensure a consistent work process is followed around new patient admission tracking in conjunction with sales team
- Evaluate the effectiveness of the intake and related program activities ensuring consistency of work processes and recommend changes
- Identify utilization trends of incomplete or inaccurate verification processes and develop appropriate work processes to respond to exceptions and minimize financial risk
- Ensure accurate, timely, and efficient reporting for intake core processes
- Develop indicators for monitoring and evaluating quality of work and meeting turnaround time standards
- Establish work directions, resolve problems, and set performance expectations and deadlines to ensure timely completion of all department deliverables
- Evaluate current procedures and practices and implement changes ensuring compliance with all related laws, regulations and contractual requirements
- Ensure all deadlines related to referral processing and turnaround times for the assigned programs are met
- Ensure up to date quality control processes to ensure integrity of enrollment and insurance verification data
- Develop and ensure a consistent work process is followed around new patient admission tracking in conjunction with sales team
- Evaluate the effectiveness of the intake and related program activities ensuring consistency of work processes and recommend changes
- Identify utilization trends of incomplete or inaccurate verification processes and develop appropriate work processes to respond to exceptions and minimize financial risk
- Ensure accurate, timely, and efficient reporting for intake core processes
Education/Experience: Bachelor's degree in related field or equivalent experience. 4+ years of intake or insurance verification experience.
Pay Range: $70,100.00 - $126,200.00 per year
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
