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Senior Clinical Administrative Coordinator - Maitland, FL
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Maitland, FL Maitland, Florida |
About this job
Position Description:
What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
Primary Responsibilities:
- Act as a Subject Matter Expert for other team members
- Manage the 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
- Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention
- Process 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
Requirements
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 of experience working in a clerical or administrative support related role.
- Working Knowledge of Medical Terminology to communicate with members and providers.
- Experience working within the healthcare industry (ie. Hospital, Physician's Office, or Medical Clinical setting).
- 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.
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