Utilization Review Intake Specialist

Who We Are

Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Ready to Be the Gateway to Quality Healthcare Management?

We're seeking a detail-oriented professional who understands that exceptional intake processes set the foundation for effective utilization management. As our Utilization Review Intake Specialist, you'll serve as the critical first point of contact, ensuring accurate information gathering and seamless request routing that supports quality healthcare decisions.

What makes this role different

✓ Healthcare access impact: Your accurate intake processes directly affect members' access to necessary medical services and treatments

✓ Process expertise: Master pre-certification workflows while providing reliable information to internal and external customers

✓ Data integrity focus: Ensure complete documentation and accurate data entry that supports downstream clinical decision-making

✓ High-volume excellence: Meet productivity and quality standards while maintaining attention to detail in fast-paced environment

What You'll Actually Do

Manage customer communications: Answer and route all incoming phone calls while providing accurate information about pre-certification processes to internal and external customers.

Gather critical information: Collect demographic, non-clinical, and provider data for pre-certification through phone, fax, inter/intranet, and various computer software programs.

Process service requests: Review and manage requests efficiently, involving appropriate departments as needed to ensure optimal resolution and workflow.

Maintain comprehensive documentation: Perform accurate data entry, maintain complete case information, assist in document maintenance, compile monthly reports, and manage logs and files.

Meet performance standards: Achieve productivity, quality, and turnaround time requirements on daily, weekly, and monthly basis while supporting team excellence.

What You Bring to Our Mission

The foundational experience:

• Associate degree preferred in business, management, or related field
• Prior experience in customer service and/or medical background
• Prior insurance and/or claims background
• Experience in medical front office, hospital patient intake, medical claims processing, or equivalent combination

The technical competencies:

• Strong written and verbal communication skills
• Proficiency in Microsoft Excel, Word, and Outlook
• Accurate data entry skills (40wpm)
• Knowledge of medical terminology; ICD-10, CPT & HCPCS coding desirable

The professional qualities:

• Ability to manage high volumes of customer service calls
• Capability to organize, prioritize, and multitask in fast-paced, deadline-driven environment
• Demonstrate ability to work independently with excellent judgment
• Strong attention to detail and commitment to accuracy in all interactions

Why You'll Love It Here

We believe in creating meaningful work experiences that fit your life—whether you're building your career, balancing other commitments, or seeking purposeful part-time opportunities.

Flexibility that actually works:

• Part-time schedule designed around your availability and life priorities
• Remote work that eliminates commute stress
• Clear expectations and boundaries that respect your time investment

Growth without limits:

• Access to learning and development opportunities alongside full-time colleagues
• Mentorship and skill-building that translates to career advancement

A culture that energizes:

• People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation
• One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges
• We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results
• Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable

The practical stuff:

• Competitive hourly compensation that values your expertise
• Proportional PTO that ensures you have time to rest and recharge
• Technology and equipment support to set you up for success

Ready to create a healthier world while building the career you want? We're ready for you.

No candidate will meet every single qualification listed. If your experience looks different but you think you can bring value to this role, we'd love to learn more about you.

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $18 to $20 per hour. Note that compensation may vary based on location, skills, and experience. Note that compensation may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

#WeAreHiring #PersonifyHealth

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.