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Our Customer Service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.
Employees in this position include those responsible for initial Triage of members, Administrative Intake of members or managing the Admission / discharge information post-notification, and working with hospitals and the Clinical team. Function 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. Also manages the Referrals process, processes Incoming and Outgoing Referrals, and Prior Authorizations. This function also includes Intake, Notification and Census roles.
This will be an on-site Clinical Administrative Coordinator at our office on Two Allegheny Center Suite 600 - Pittsburgh, PA 15212.
Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
Drafting of NOA / NOE letters for government and Commercial Specific clients
Responsible for ensuring the letter documentation meets client, regulatory and accreditation requirements
Knowledge of the State and Federal regulations concerning the services and benefits.
Must demonstrate understanding of the program by selecting the correct letter template
Other duties as assigned by manager and / or director
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.