Job Details

ID #21684772
State Texas
City San antonio
Full-time
Salary USD TBD TBD
Source UnitedHealth Group
Showed 2021-10-24
Date 2021-10-25
Deadline 2021-12-23
Category Et cetera
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Medical Claims Review Coordinator

Texas, San antonio, 78201 San antonio USA

Vacancy expired!

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)Like you, UnitedHealth Group is strong on innovation. And like you, we'll go the distance 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 a chance to make an impact.Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:Manage administrative intake of members

Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers

Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles

Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review

Handle resolution/inquiries from members and/or providers

Moderate work experience within own function

Some work is completed without established procedures

Basic tasks are completed without review by others

Supervision/guidance is required for higher level tasks

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:HS Diploma or GED

2+ years of customer service experience

Experience with MS Word, Excel and Outlook

Preferred Qualifications:Experience working within the health care Industry and with health care insurance

Experience working in a hospital, physician's office or medical clinic setting

A clerical or administrative support background

Knowledge of ICD-9 and CPT codes

Experience working in a call center

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.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: Medical Claims Review Coordinator, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

Vacancy expired!

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