Intake Representative

Role Overview

This remote Intake Representative position focuses on accurate intake and case preparation within a fully digital workflow. You’ll review incoming requests for utilization review and other medical management services, confirm that submissions are complete, and make sure each case is ready for clinical assessment.

The work requires moving information between multiple systems, checking eligibility, verifying claim and provider details, comparing documents from different sources, and following up when additional information is needed. The role combines queue-based processing with inbound phone support, so you’ll need to manage priorities independently throughout the day.

To succeed here, you should already have a solid background supporting healthcare operations, be comfortable with medical terminology, and have a strong eye for detail when reviewing documentation for accuracy and completeness.

This role requires residence in the Mountain Time Zone and availability Monday through Friday, 8:00 AM to 5:00 PM MST.

About Comagine Health

Comagine Health is a mission-driven nonprofit with more than 50 years of experience in health care quality consulting and quality improvement. The organization partners with front-line providers and other health care stakeholders to strengthen care delivery and improve patient outcomes.

The company supports a distributed workforce across the United States and emphasizes remote work as a long-term model, offering flexibility, work-life balance, and an annual stipend to help employees improve their home workspace.

Responsibilities

• Review requests submitted through the provider portal to confirm they are accurate and complete.
• Check whether the medical information provided is sufficient for clinical review based on the request type.
• Pull supporting clinical information from client systems or contact providers when more detail is needed.
• Use training to determine when a scripted review is required under contract rules.
• Finalize requests after clinician or manager review so letters sent to providers contain complete language and determination details.
• Handle inbound calls and record them clearly in the care management system.
• Enter case details from source documents or verify data entered by providers in the portal.
• Place courtesy calls using case reference numbers.
• Notify relevant parties when a review is complete or when more information is required.
• Help orient and train other non-clinical team members.
• Create templates for complex reviews, support internal quality checks, and assist with provider outreach when needed.
• Perform scripted clinical reviews when assigned and escalate cases that need further review.
• After physician review, communicate decertification or possible denial decisions by phone or in writing when required by contract.
• Close cases after review and route them back to a clinician or client according to procedure.
• Coordinate ancillary authorization requests such as transportation and accommodation.
• Obtain customer consent for care management services.
• Communicate with facilities, providers, and other contacts as needed.
• Support non-clinical coordination and intervention tasks as directed.
• Complete supervised case closure once clinical review is finished.

Requirements

• High school diploma or equivalent is required; comparable education and/or work experience in a related field may be accepted in place of the diploma.
• At least 2 years of relevant work experience or customer service experience.
• At least 1 year of healthcare work experience.
• Preferred: post-secondary education or certification in a related field.
• Preferred: 2 years of healthcare experience, including nursing assistant or medical assistant experience.
• Intermediate knowledge of medical terminology.
• Intermediate skill level with Microsoft Office Suite.
• Demonstrated ability to work accurately with medical terminology and detailed documentation.
• Comfort working independently in a remote, queue-driven environment.
• Availability to work Monday through Friday from 8:00 AM to 5:00 PM MST and reside in the Mountain Time Zone.
• Reliable internet access and a distraction-free home workspace.
• Ability to sit for long periods and communicate effectively using computers, phones, and virtual tools.
• If business driving is required, a valid driver’s license and the organization’s driving eligibility standards must be met.

Benefits

• Medical, dental, and vision coverage.
• Paid time off for vacation, illness, and volunteering.
• Retirement savings plan with employer contribution.
• Adoption financial assistance.
• Paid parental leave.
• Annual stipend to support and personalize your home workspace.
• Additional employee benefits beyond those listed.

Additional Information

Comagine Health is an equal opportunity employer and is committed to maintaining a diverse, equitable, and inclusive workplace.

The role is primarily performed from a home office and requires a reliable internet connection along with a workspace that is free from major interruptions.

Reasonable accommodations will be provided to qualified individuals with disabilities so they can perform the essential duties of the role.