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Clinical Administrative Coordinator - Downers Grove, IL

02/27/2018Call Center
Job Location:
Downers Grove, IL
Metro Area:
IL - Chicago
Company Name: UnitedHealth Group
Website:  Click to Visit
UnitedHealth Group
Position Description: Energize your career with one of Healthcare’s fastest growing companies.     You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.   This opportunity is with one of our most exciting business areas: Optum –a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.   Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance. 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 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.Primary Responsibilities:Manage administrative 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 rolesReceive care coordination notification cases for non-clinical assessment / intervention and provide appropriate triageReview requests for adverse determination, approval notification and processing 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 usageModerate work experience within own functionSome work is completed without established proceduresBasic tasks are completed without review by othersSupervision / guidance is required for higher level tasks


Required Qualifications:High School Diploma / GED (or higher)2+ years of Customer Service experience analyzing and solving customer problems1+ years of experience working in a Call Center environment taking Inbound CallsAbility to create, edit, save and send documents utilizing Microsoft Outlook, Microsoft Word, and Microsoft ExcelAbility to navigate a PC to open applications, navigate web, send emails, and conduct data entryPrevious experience working with high volume inbound calls   Preferred Qualifications:Experience making outbound calls to membersExperience working within the Healthcare IndustryExperience working with Healthcare InsuranceExperience working with ICD-10 and CPT codesExperience working with Medicare and / or Medicaid ServicesWorking knowledge of Medical Terminology to communicate with members and providersCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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, Healthcare, Optum, Clinical, Administrative
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