Job Title
Medical Management Intake Specialist
Location
Detroit, MI
Schedule
100% Remote (Local candidates ONLY – must be within reasonable proximity to Detroit, MI for onsite support as needed)
Type
6?Month Contract
Pay: $22–24/hour (W2)
Summary
The Medical Management Intake Specialist provides frontline support to healthcare providers and internal clinical teams by managing utilization management (UM) intake activities. This role is responsible for handling inbound and outbound provider communications, processing prior authorization and compliance requests, maintaining accurate documentation, and ensuring efficient coordination across UM programs. The position is fully remote but requires local availability for onsite support if needed. Candidates must be comfortable with rotating weekends and holidays.
Key Responsibilities
- Serve as the primary intake point for utilization management and prior authorization requests.
- Handle inbound and outbound phone calls with healthcare providers, facilities, and internal teams.
- Accurately review, process, and route provider requests in accordance with UM guidelines.
- Enter clear, concise, and accurate documentation into Care Advance and related systems.
- Act as a trusted first point of contact for providers regarding UM and prior authorization programs.
- Assign incoming faxes to appropriate staff and manage UM department mailboxes and voicemail.
- Process compliance inquiries and support documentation requirements.
- Collaborate closely with nurses, peers, and cross?functional teams to ensure timely request resolution.
- Analyze information to identify trends, resolve issues, and support efficient decision?making.
- Maintain a high level of customer service while explaining complex insurance processes clearly.
- Work independently while meeting productivity, accuracy, and quality standards.
- Support rotating Saturday, Sunday, and holiday coverage as scheduled; overtime may be required.
Required Qualifications
- Minimum of 2 years of experience in a healthcare, insurance, or related field.
- High school diploma required; college or university experience preferred.
- Medical terminology knowledge or medical background required.
- Strong understanding of health insurance processes, including claims, benefits coordination, and prior authorizations.
- Proven customer service experience.
- Strong phone skills with experience handling both inbound and outbound calls.
- Experience using healthcare management software and databases.
- Excellent verbal and written communication skills.
- Ability to clearly explain complex information.
- Strong analytical, problem?solving, and critical?thinking skills.
- High attention to detail and accuracy.
- Ability to collaborate effectively with cross?functional teams.
Preferred Qualifications
- Two years of college or associate?level degree (or equivalent experience).
- Experience providing high?quality, provider?focused servicing to facilities and physicians.
- Experience working collaboratively with nurses and clinical teams.
- Prior experience with Care Advance documentation.
- Experience processing provider requests and compliance inquiries.
- Ability to function independently in a fast?paced environment.
- Bilingual (Spanish) a plus.
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