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TRICARE Prior Authorization Coordinator - Phoenix, AZ
| Hours | Full-time, Part-time |
|---|---|
| Location | Phoenix, AZ Phoenix, Arizona |
About this job
Talk
about meaningful work. Talk about an important role. Let's talk
about your next career move. Our UnitedHealthcare Military &
Veterans organization has been selected to provide quality health care
services for those who serve our nation. This is an opportunity to
share in something special; an opportunity for all of us to serve those
families who have made our nation stronger. It's an inspiring role and
it can inspire your career. Find out more about these opportunities to do your life's best work.(sm)
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.
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:
- Respond to incoming provider and enrollee calls;
- Resolve customer service inquiries which could include:
- Entering notifications & providers' status of an existing notification, and determining if notification is required;
- Complete notification wizard along with ICD-9 and CPT coding;
- Provide excellent customer service to both providers and enrollees;
- Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance;
- Assist with faxes and emails;
- Flexibility and willingness to work additional mandatory overtime hours as needed, as dictated by business needs;
- 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.
Requirements
- High School Diploma/GED.
- Must be open to working within the operation hours of
the site with a possible 7% shift differential depending on the shift
assigned. - Must be available to work anytime within the operating hours of the site.
- 2+ years of Customer Service experience.
- 1+ year of experience using the telephone and computer as the primary instruments to perform the job duties.
- Able to navigate a PC environment and utilize Microsoft Office in a professional setting.
- United States Citizenship.
- Ability to obtain favorable adjudication following submission of Department of Defense form SF86 .
- Medical Terminology/Coding (ICD-9 and CPT).
- Healthcare experience.
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 ,
(the National Agency Check or “NACâ€). 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: 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.
Keywords: Prior Authorization, telephone and computer, customer service, healthcare, evening shift Phoenix, AZ
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