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Clinical Administrative Coordinator - Tampa, FL
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Tampa, FL Tampa, Florida |
About this job
Position Description:
Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Due to our expanding business, UnitedHealth Group is seeking Clinical Administrative Coordinators who share our passion for helping others live healthier lives. As one of the world's leading health care companies, UnitedHealth Group is pursuing innovative new ways to operate our service centers and improve on our ability to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. Take this opportunity and begin doing your life's best work. (sm)
Primary Responsibilities:
- Manage Administrative intake of members or the admission/discharge information post notification.
- Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers.
- Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles.
- Receive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triage.
- Review requests for adverse determination, approval notification and processing notification requirements.
- Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review.
- Handle resolution/inquiries from members and/or providers that may include:
- Benefit and Eligibility information.
- Billing and Payment issues.
- Customer material requests.
- Physician assignments.
- Authorization for treatment.
- Explanation of Benefits (EOB).
- Verifying appropriate ICD-9 and CPT coding usage.
Requirements
Required Qualifications:
- High School Diploma/GED.
- 2+ years of experience working in a professional Office setting using a telephone and computer as the primary instruments to perform job duties.
- Experience using a computer and Microsoft Office (MS Word, MS Excel, and MS Outlook).
- 1+ year of Healthcare Industry experience working at a Hospital, Physician's office, Medical Clinical office, or Insurance Benefits environment.
Preferred Qualifications:
- Working knowledge of Medical Terminology.
- Working knowledge of CPT or ICD-9 coding.
- Call Center experience.
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.