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in Fort Worth, TX
Care Team Associate for WellMed - Fort Worth, TX
Hours | Full-time, Part-time |
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Location | Fort Worth, TX Fort Worth, Texas |
About this job
Primary Responsibilities:
- Receives and responds to escalated Care Coordination inquiries from all communication venues: e.g. phone queue, portal, claim queue, department e-mail box or fax
- Coordinates and assists initial screening of complex case screening and UM requests via all communication venues; as well as administrative preparation for clinical staff
- Conducts in-bound and out-bound calls for program requirements including, but not limited to: patient scheduling, surveys/screenings, reminder calls, census management and distribution of materials to appropriate clinical personnel or patients
- Performs daily Inpatient Census reconciliation to include monitoring of UM concurrent in-patient cases in pend status to ensure adherence to CMS regulations
- Participates in market Patient Care Committees: prepares agenda and minutes
- Assembles and mails various educational materials, supplies, and medical equipment to patients and clinical staff based on need and direction from nursing personnel
- Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as needed
- Completes effective data entry of in-bound and/or out-bound call contact information into software applications (Claims Database, DM database, and EMR, CWQI, etc.)
- Utilizes various reports to track patient referrals or no-shows for scheduling visits with clinical staff
- Completes calls/assignments and ensures census management, productivity weekly and monthly standards are met
- Provides clerical and/or administrative support to clinical staff and managers for special studies, projects and reports
- Provides excellent customer service by serving as a resource to all internal and external customers
- Attends required meetings and participates in special committees as needed
- Performs other duties as assigned
- Coordinates all aspects of IDTC from data mining and reporting by market, scheduling, notification to members, preparing agenda and recording of minutes
- Maintains knowledge of all health plan benefits, network, CMS, regulations, health plan and/or MSO policies
- Maintains collating, gathering and logs for Notice of Medicare Non-Coverage (NOMNC)
- Non-Clinical staff are not responsible for conducting any UM review activities that require interpretation of clinical information
- Performs all other duties as assigned
Requirements
Required Qualifications:
High School Diploma or GED
2+ years of administrative support experience
- Able to work independently, with some supervision and direction from manager
Possesses medical terminology knowledge base
Possess and demonstrate excellent organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers and managers
Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
Maintain strict confidentiality at all times to include but limited to patients and coworkers
Comply with all organizational policies regarding ethical business practices
Adhere to all department policies and procedures
Basic knowledge of Microsoft Office products, including Word and Outlook
Preferred Qualifications:
Certified Medical Assistant training or certification
Additional years of experience working in a medical care setting as a receptionist or medical assistant
Bilingual language proficiency (English/Spanish)
Basic knowledge of Microsoft Office products, including Excel and PowerPoint
Physical & Mental Requirements:
Ability to lift up to 25 pounds
Ability to push or pull heavy objects using up to 25 pounds of force
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.SM
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Certain positions are subject to random drug testing.
Job Keywords: Medical Office Specialist, Medical Receptionist, Patient Care Tech, CMA, RMA, Medical Secretary, Administrative Assistant, Home Health, WellMed, Clinic, Fort Worth, TX, Texas