Clinical Administrative Coordinator - Sugar Land, 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)

Positions in this function includes those
responsible for working with hospitals and providers and the clinical team.
Includes managing outbound and inbound 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.



Primary Responsibilities:

• Make outreach calls to members to encourage preventative
  health reminders
• 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
• 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

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.
• 2+ years experience in a Clerical or Administrative support related role.

Preferred Qualifications:

• Experience
  working within the Healthcare Industry.
• Experience working with Healthcare Insurance.
• Experience working in a Hospital, Physician's
  Office, or Medical Clinical setting.
• Working Knowledge of Medical Terminology to
  communicate with members and providers.
• Experience working with ICD-9 and CPT codes.
• Experience working with Medicare and/or Medicaid
  Services.
• Experience working in a Call Center environment.