Clinical Administrative Coordinator - Telecommute (PST)

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 pre 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
• Customer material requests
• Physician assignments
• Authorization for treatment
• 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.
• 1+ year of experience using Microsoft Word and Excel.
• Must be able to navigate a PC computer and Windows applications.

Preferred Qualifications:

• Bachelor's Degree.
• Experience working within the Healthcare Industry including Hospital, Physician's Office, and 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.
• Experience with Outlook.

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.