Clinical Administrative Coordinator - US Telecommute

Position Description:

UnitedHealth
Group is working to create the Healthcare system of
tomorrow and you can help. Already Fortune 17, we are totally focused on
innovation and change.  We work a little
harder. We aim a little higher. We expect more from ourselves and each other.
And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're
building a high-performance Healthcare system that works better for more people
in more ways than ever. Now we're looking to reinforce our team with people who
are decisive, brilliant and built for speed. 
Join with us and start doing your life's best work.SM

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.


• 6+months of previous experience in a Professional office setting using a telephone and computer as primary instruments to perform job duties.
• 6+ months of previous work experience in a Clerical or Administrative role.
• Must be able to navigate a PC environment and utilize Word and Excel in a professional setting.
• Must be able to work Monday - Friday or Tuesday - Saturday shifts as required.

Preferred
Qualifications:

• Experience
  working within the Healthcare Industry.
• Customer Service experience analyzing and solving customer problems.



• 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.
• Associate's Degree or higher.
  

Careers
with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17
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
wherever 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, 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.