Associate Patient Care Coord - Benefit & Eligibility, Del Webb

Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Due to our expanding business, UnitedHealth Group is seeking Associate Patient Care Coordinators who share our passion for helping others live healthier lives. As one of the world's leading health care companies, UnitedHealth Group is pursuing innovative new ways to operate our service centers and improve on our ability to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. Take this opportunity and begin doing your life's best work.(sm)
 
Primary Responsibilities:


Provide high level of customer service while communicating with internal departments and external provider office staff as pertains to performance of job duties

Review and process prior authorization requests to meet departmental key indicator productivity

Verify patient insurance eligibility & benefits to include applicable co - pays, co - insurances, deductibles, Out of Pocket Maximum, appropriate service facilities, services covered and which services if any require prior authorization

Demonstrate knowledge of insurances including navigating websites for online benefit reviews

Answer incoming calls regarding benefits, eligibility, authorizations & referrals as well as other inquiries as it relates to health insurance and acts as Patient Advocate

Process adverse determinations; timely notification and thorough documentation

Respond to complex customer calls

Resolve customer service inquiries which could include Benefit and Eligibility information, Authorization for treatment, Specialists Orders / Referrals

Must be able to work independently

Submit Specialists Referrals with appropriate clinical information using established protocols & procedures

Exceed attendance standards set by company policy

Take responsibility of problem solving

Knowledge or the ability to learn & apply to job functions
Excellent interpersonal skills
Excellent oral and written communication skills
Good composition skills
Ability to listen, document, and track problems within the system, while on calls
Follow through thoroughly with daily issues
Ability to respond in difficult situations both on the telephone and in-person
Maintain a positive attitude supporting department goals and objectives
Strong organizational skills
Flexible and able to commit to department goals, including but not limited to, overtime as needed and / or shift changes

Required Qualifications:

2+ years experience in a high volume medical clinic; multi-specialty setting
High school education or equivalent 

Knowledge of benefits & medical terminology
Preferred Qualifications:

Knowledge of local HMO / PPO / Medicare plans preferred
Bi-lingual Spanish strongly preferred
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
 
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and 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.
 
Job Keywords: Front Desk, Medical Assistant, Receptionist, Healthcare, Clinical, Administrative, Las Vegas, NV, Nevada