Vacancy expired!
What you do matters. And who you do it for matters even more. If you're looking for more meaningful impact, you should take a serious look at our growing organization. Since our founding in the mid-90's, Peoples Health has brought innovation and compassion to Medicare patients throughout Louisiana. Now, part of the UnitedHealth Group family of companies, our team consists of over 900 people who are experienced in all aspects of care delivery, health maintenance and administrative support. It's our goal to help guide over 60,000 Medicare recipients across the broad spectrum of health and dental services. We're committed to the highest purpose; improving lives. And that makes us the singular place to do your life's best work.The Authorization Coordinator
(Clerical) is responsible for providing administrative support by means of
receiving, reviewing, sorting, tracking and distributing documents in a timely
manner.The Authorization Coordinator (Clerical) reports to the Authorization Division Supervisor and/or Manager and are responsible for ensuring that reports and documents received are entered into the system and assigned to the appropriate staff for review. All staff will maintain the mission of Peoples Health as outlined in the Mission Statement.Primary Responsibilities:
Support health information technology (HIT) in health care quality improvement
Works in coordination company-based security health information systems technology to ensure appropriate documentation of the member’s care coordination and record.
Participates in ongoing training to ensure the records are accurate and secure.
Follows corporate instruction based on Federal and State guidance related to health information documentation and security.
Receives, reviews, documents, sorts and distributes work received.
Responsible for initial inquiry into the system to determine eligibility, duplication of services, and previous authorizations for members.
Responsible for reviewing the completeness of the request, initial data entry of authorization request information and builds the administrative component of the authorization.
Forwards all pended authorizations requiring clinical review to the licensed nurse for clinical interpretation and determination of appropriate criteria to review.
Prepares cases for Medical Director review when appropriate.
Assists in obtaining medical/clinical information from the providers as directed by the respective team member, Supervisor or Manager as it pertains to the referral process.
Responsible for written and/or oral notification to the providers and members when appropriate and approved as needed.
Non-clinical staff will not conduct any activity that requires interpretation of clinical information.
When processing an authorization, is responsible to direct any questions or discuss any issues with the licensed health professional who is immediately available.
Cross trains to support and maintain administrative activities in the authorization division.
Responsible for issuing authorization numbers to the requesting Physician or Specialist when appropriate and approved by the licensed health professional.
Works daily error reports.
Responsible for re-authorization of requests that do not require clinical review.
Provides Business Continuity Plan coverage as assigned.
Log into phone queue to accept telephone inquiries from providers regarding notifications or authorization numbers.
Responsible for ensuring that quality outcomes set by the department’s leadership are consistently met to maximize member experiences with service delivery.
Performs all other duties as assigned.
Core Competencies
Utilize effective means of both oral and written communication in order to gain members’ comprehension of encounter
Be professional by being prompt, dependable and prepared
Be a team player and to collaborate and work effectively with team members by displaying a helpful, pleasant and positive attitude and a willingness to adapt to change
Comprehend and adhere to policies and procedures
Utilize time management skills efficiently and effectively in order to handle multiple demands of diverse workload, organize and prioritize critical issues in order to meet daily deadlines
Read, comprehend both written and oral communications and apply the information at hand
Work independently and pro-actively and carry-out assignments to completion with minimum assistance
Perform accurate work with a strong attention to detail
Appreciate the diversity of work styles
Display a high level of integrity and respect for confidentiality and adhere to regulatory and PH policies and procedures
Required Qualifications:
High School Diploma / GED or higher
Computer / typing proficiency to enter / retrieve data in electronic clinical records and documentation systems; experience with email, internet research, use of online calendars and other software applications
Preferred qualifications:
Some college
Coding experience
Experience in healthcare and / or managed care
Experience with medical terminology and coding
Understanding of healthcare industry
Careers at UnitedHealthcare Medicare & Retirement . The Boomer generation is the fastest growing market segment in healthcare. And we are the largest business in the nation dedicated to serving their unique health and well - being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our Healthcare system. Ready? It's time to do your life’s best work.SMDiversity 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.Key Words: PeoplesHealth; Metairie, LA; UHC; Clerical; Medicare; authorizations; pre-certification
Vacancy expired!