Position Description:Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.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 Senior Clinical Administrative 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.SMWhat 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.This is a team of that helps support field managers of case management and field care coordinators to help betters serve our members from an office setting. The candidate will work alongside peers on projects and work as each other's backups and report to 1 supervisor even though they are helping support MCMs and CCs who are out in the field. This team is heavily involved with obtaining documents for quality audits for our state partners. Primary Responsibilities:Act as a Subject Matter Expert for other team membersManage the intake of members or the admission / discharge information post notificationWork with hospitals, clinics, facilities and the clinical team to manage request for services from members and / or providersManage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census rolesProvide appropriate triage and care coordination notification cases for non-clinical assessment / interventionProcess notification requirementsAssist the clinical staff with setting up documents / triage cases for Clinical Coverage ReviewHandle resolution / inquiries from members and / or providers that may include:Benefit and Eligibility informationBilling and Payment issuesCustomer material requestsPhysician assignmentsAuthorization for treatmentExplanation of Benefits (EOB)Verifying appropriate ICD-10 and CPT coding usage
Required Qualifications:High School Diploma or GED2+ years of Customer Service experience analyzing and solving customer problemsAbility to create, edit, save and send documents utilizing Microsoft Word and ExcelAbility to navigate a PC to open applications, send emails, and conduct data entry6+ months of experience working within the Healthcare IndustryWorking knowledge of Medical Terminology to communicate with members and providersPreferred Qualifications:Experience working with Healthcare InsuranceExperience working in a Hospital, Physician's Office, or Medical Clinical settingProfessional experience in a Clerical or Administrative Support related roleExperience working with ICD-10 and CPT CodesExperience working with Medicare and / or Medicaid ServicesExperience working in a Call Center environmentCareers 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.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.Keywords: UHG, Overland Park, KS, customer service, healthcare, telephonic, patient interaction, Field base, advocacy
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.