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Tuesday - Saturday Clinical Administrative Coordinator - Cypress, CA or Miramar, FL
| 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, turnaround 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. - Must be able to create, copy,
edit, send & save utilizing Word, Excel & Outlook - 1+ year of experience with
Medical Terminology.
Preferred
Qualifications:
- 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. - Experience in a Medical Office
environment, Medical Assistant, or Hospital 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, 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.
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