Clinical Administrative Coordinator - Brentwood or Knoxville, TN - Full-time / Part-time

Position Description:

Energize your career with one of Healthcare's fastest growing companies.  

You dream of a great career with a great company - where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our Service Centers, improve our Service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

Primary Responsibilities:

• Manage administrative intake of members or the admission/discharge information post notification 


• 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


• 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


• 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.


• Must be able to type at least 45 WPM and navigate Windows PC applications


• 2+ years of Customer Service experience analyzing and solving customer problems.


• 1+ year of experience with Microsoft Word and Excel.


• Proven ability to meet critical deadlines consistently while completing tasks accurately

Preferred Qualifications:

• Bachelor's Degree or 4+ years of equivalent work experience in a managed care environment


• Experience working within the Healthcare Industry including hospital, physician's office, or medical clinic


• 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-9 and CPT codes


• Experience working with Medicare and/or Medicaid Services


• Experience working in a call center environment

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: customer service, call center, intake, prior authorization, medical assistant, administrative, clerical, coordinator, claims.