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Clinical Administrative Coordinator - Cypress, CA
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Cypress, CA Cypress, California |
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)
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:
- 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, turn around 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.
- 1+ year of experience with Medical Terminology.
- 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.
- Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, and long periods of close vision looking at a computer monitor.
- Service Center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity.
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, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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