Clinical Administrative Coordinator - Richardson, TX - Full-time / Part-time

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:


Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers.
Prior authorizations, approvals & denials, network GAP review
Work with providers to complete the authorization file (faxes, making outbound calls)
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.
Verifying appropriate ICD-10 and CPT coding usage.

Required Qualifications:

High School Diploma/GED.
2+ years of Customer Service experience analyzing and solving customer problems.
Must be able to create, edit, save and send documents utilizing Microsoft Word and Excel.
Must be able to navigate a PC to open applications, send emails, and conduct Data Entry.
1 + year of Healthcare/Insurance or related field experience.
Preferred Qualifications:

Experience working in a Hospital, Physician's Office, or Medical Clinical setting.
Professional experience in a Clerical or Administrative Support related role.
Working Knowledge of Medical Terminology to communicate with Members and Providers.
Experience working with ICD-10 and CPT codes.Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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.