Behavioral Health Intake Specialist

Description

POSITION SUMMARY:

The Behavioral Health Intake Specialist is the first point of contact for individuals, families, and referral partners seeking mental health services through SCCS. This is a high-accountability, revenue-generating role that operates across two distinct intake systems: county Medi-Cal (behavioral health contracts with San Bernardino and Orange Counties) and managed care/commercial insurance. The goal of every contact is a scheduled first appointment. Performance is measured on conversion rate, call quality, and documentation accuracy.

JOB DUTIES & RESPONSIBILITIES:

Intake and Conversion

• Answer all inbound calls from individuals, families, school district partners, hospital discharge planners, county case managers, and payer representatives seeking SCCS services across San Bernardino and Orange Counties. Follow up on all faxes and emails regarding referrals to our county Medi-Cal programs.
• Conduct a standardized needs screen on every contact to determine program fit, payer eligibility, geographic coverage, and level-of-care alignment within SCCS’s program continuum.
• Schedule every eligible caller for an assessment before ending the call. Callers with Medi-Cal are scheduled directly; managed care and commercial insurance callers are scheduled once eligibility and any prior authorization requirements are confirmed. 
• Correctly represent SCCS’s full program matrix, payer acceptance, and geographic service area on every call. Coverage and authorization information should only be communicated once it has been verified during that contact.

Insurance Verification

• County Medi-Cal: Confirm eligibility via MEDS or county-designated verification tools. Determine whether the caller falls under a county behavioral health plan contract (San Bernardino or Orange County, for specialty mental health services) or a managed care plan (for mild-to-moderate conditions). Apply Short-Doyle/Medi-Cal documentation protocols and county-designated timely access standards. 
• Managed care and commercial insurance: Verify benefits in real time via payer portals or direct payer contact. Confirm SCCS is in-network for the caller’s specific plan type and service category. Determine deductible status, co-pay, out-of-pocket maximum, and visit limits. Identify prior authorization (PA) requirements and initiate or hand off the PA process before scheduling. Document all verified benefit information in MyEvolve/EHR at time of call. For EAP callers, confirm session authorization and employer plan parameters before scheduling.

Scheduling and Coordination

• Book first appointments before the call ends. Confirm appointment details with the caller, including telehealth instructions, required documentation, and any intake paperwork to be completed before the first visit. Track scheduled appointments and follow up on no-shows per SCCS protocol.
• Handle calls from hospital discharge planners, county case managers, school district administrators, care coordinators, and payer representatives with the same accuracy and responsiveness as direct client calls. Provide referral partners with timely confirmation of intake receipt, next steps, and any documentation requirements. Escalate referral partner concerns to the Manager of Intake Operations.

Crisis Escalation

• Identify and escalate calls involving suicidal ideation, homicidal ideation, acute psychiatric crisis, or other safety presentations to licensed clinical staff in real time, following SCCS’s crisis warm handoff protocol. Apply structured de-escalation techniques for distressed callers who do not meet clinical crisis criteria. Document all crisis contacts in MyEvolve/EHR at the time of the call.

Documentation and Compliance

• Enter accurate, complete intake records in MyEvolve/EHR at the time of each contact, including referral source, program assignment, payer and plan information, eligibility and authorization status, appointment details, and all follow-up actions. Support data integrity for payer audits, DHCS reporting, and internal performance monitoring. Maintain compliance with HIPAA across all contact channels.

Performance Standards

• Target referral-to-conversion rate of 65–85%, dependent on program. All calls are monitored; call quality, first-call resolution, and documentation accuracy are reviewed monthly. Accuracy of program and coverage information is a primary quality standard. Participate in call review sessions, apply coaching feedback, and engage in workflow improvement initiatives as directed.
• Performs other related duties as required and assigned.

Requirements

GENERAL REQUIREMENTS

Education/Experience

1. Associate’s degree or higher in psychology, social work, healthca