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Clinical Administrative Coordinator - Cypress, CA - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Cypress, CA Cypress, California |
About this job
Position Description:
Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM
Our Customer Service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.
Primary Responsibilities:
- Review requests for adverse determination(s) and approval notifications.
- Determine appropriate letter templates to be generated.
- Create letters in appropriate letter generation system or manual letter template.
- Knowledge of State and Federal Regulations pertaining to letter notification, turn around time, and licensure.
- Review denial language rationale and notify Medical Director if language needs to be corrected.
- Audit letter prior to letter being mailed/faxed to the member/provider.
- Communicate with Medical Directors, Clinical Services staff, and management.
- Meet productivity standard.
- Update letter database.
Requirements
Required Qualifications:
- High School Diploma/GED.
- Ability to work Tuesday through Saturday, 8:00 am - 6:00 pm, PST.
- 2+ years of experience in an Office setting using the telephone and computer as the primary instruments to perform the job duties.
- 2+ years of professional experience in Clerical or Administrator work.
- 1+ year of experience with Medical Terminology.
- Previous Customer Service experience interacting with Physicians and Registered Nurses.
- Familiarity with reviewing Medical documentation.
- Experience with CPT or ICD-9 Coding.
- Previous Health Plan experience.
- Healthcare or Insurance Benefits experience.
- Experience in a Hospital, Physician, or Medical Clinical setting.
- Medicare and/or Medicaid experience.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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