TRICARE Clinical Administrative Coordinator - Phoenix, AZ - Full-time / Part-time

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. 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.This position works under the direction of the Clinical Quality Management (CQM) Medical Records Manager. The Medical Records Clerk processes requests for medical records for potential quality issues, studies, TRICARE Quality Monitoring Contractor (TQMC) requests, and other activities involving medical records. Maintains compliance with TRICARE requirements. Maintains confidentiality of all quality assurance activities and protects all personal health information (PHI) in accordance with all rules and regulations. 
Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles.

As a potential government contractor, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF85P.
Primary Responsibilities:

Process requests for medical records.
Mail or fax requests for medical records to facilities and providers within process timelines.
Calls facilities and providers for status of requested documents.
Document and track status of all medical record requests in medical records database.
Files and maintains received medical records and CQM documents per file plan.
Processes mail received in the CQM department.
Prepare and transfer medical records to the TQMC to meet contract delivery timeline requirements.
Processes invoices for received medical records.
Maintains and ensures the organization of the medical records room.
Archives records when appropriate and per policies and procedures.
Assists clinical staff with the assembly of case files.
Performs all other duties as assigned.
Moderate work experience within own function.
Some work is completed without established procedures.
Basic tasks are completed without review by others.
Supervision/guidance is required for higher-level tasks.

Required Qualifications:

High School Diploma/GED.
Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86.
United States Citizenship.
Computer skills, including experience with Microsoft Word and Outlook, as well as the ability to navigate a Windows environment.
Ability to maintain confidentiality and adhere to HIPAA requirements.
Preferred Qualifications:

Any prior Medical or Healthcare experience in a professional setting.
Any experience with EMR (Electronic Medical Records)
As a requirement of UnitedHealth Group’s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or NAC).  Successful completion of the NAC process is a requirement for continued employment in this role.  NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense.  Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received.  Failure to obtain final NAC approval will result in termination from this role.
 
UnitedHealthcare Military & Veterans is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.
We serve those who serve our nation, providing quality health care services to millions of military beneficiaries across the (list region post award).
Our commitment to helping people live healthier lives, and to continue the honor, satisfaction, and quality of the TRICARE military health benefit program is greater than ever. Our efforts complement the Military Health System to demonstrate the best blend of public and private health care solutions.
It's not just business as usual. It is one of our proudest endeavors.
 
If you're ready to help make health care work better for those who serve our nation. If you are smart, creative, and committed. If you want to make a difference. Consider being part of the elite team at UnitedHealth care Military & Veterans.
This is an opportunity to share in something special; a chance for all of us to serve, to excel, and to know that we've made a difference for those families who have made our nation stronger.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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.