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.What 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. As a Senior Clinical Administrative Coordinator, you will ensure all Notices of Action and Extension letters comply with applicable client, federal and state rules, laws, consent decrees, and accreditation standards. You will coordinate internal reviews on denial letters to determine compliance with contractual and regulatory requirements of the State and Federal programs, while reviewing for efficiencies and effectiveness of procedures. This will be an office based role in Honolulu, HI. Primary Responsibilities:Manage the requests for NOA / NOE lettersPrepare letters for audit reviewIdentify gaps in compliance with letters and ensure letter corrections are made within regulatory timeframesMaintain extensive knowledge of regulatory and accreditation requirementsAct as SME for lettersProficient in interpreting benefits, contracts, and medical policyMaintain knowledge of UHG guidelinesDemonstrate flexibility, availability, and dependability to conform to position responsibilities
Required Qualifications:High School Diploma or GED2+ years of experience in an office setting using the telephone and computer as the primary instruments to perform the job duties1+ years of experience with medical terminology1+ years of experience reviewing medical documentationKnowledge of State and Federal RegulationsManaged care experience or experience with a regulatory or accredited bodyProficiency with Microsoft Word, Microsoft Excel and Microsoft OutlookAvailable to work Tuesday - Saturday work schedulePreferred Qualifications:Bachelor's Degree or higherPrevious experience generating adverse determination lettersCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work. 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. Keywords: UHG, Honolulu, Hawaii, Healthcare, Clinical, Administrative
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.