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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 a Clinical Administrative Coordinator who shares 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:
Make outreach calls to members to encourage preventative health reminders
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
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
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:
High school Diploma or GED
2+ years of Customer Service experience analyzing and solving customer problems
2+ years of experience in a Clerical or Administrative support related role
Intermediate or higher level of proficiency with Microsoft Word and Excel
Proficiency with a PC that includes the ability to open applications, send emails, and conduct data entry on the computer
Preferred Qualifications:
Experience working within the Healthcare Industry
Experience working with Healthcare Insurance
Experience working in a Hospital, Physician's Office, or Medical Clinical setting
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
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to 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.Job Keywords: Customer Service, Administrative, Clinical, healthcare, health insurance, hospital, Medicare, Medicaid, call center, ICD-9, CPT, medical terminology, Sugar Land, Texas, TX
Vacancy expired!