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Clinical Administrative Coordinator - Honolulu, HI

06/20/2018Call Center
Job Location:
Honolulu, HI
Metro Area:
HI - Honolulu
Company Name: UnitedHealth Group
Website:  Click to Visit
UnitedHealth Group
Like you, UnitedHealth Group is strong on innovation. And like you, we'll go the distance 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 a chance to make an impact. Primary Responsibilities:Respond to incoming provider and enrollee callsProvide excellent Customer Service to both providers and enrolleesConstantly meet established productivity, schedule adherence, and quality standards while maintaining good attendanceReceives Care Coordination notification cases for non-clinical assessment / intervention and provides appropriate triageProcesses out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate productsProcesses notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issuesProcesses letters within DOL time framesVerifies appropriate ICD-10 and CPT coding usageCommunicates to providers and members benefit determinations within DOL time framesAssist with faxes and emailsModerate work experience within own functionSome work is completed without established proceduresSupervision / guidance is required for higher - level tasksFull-time schedule: Monday - Saturday availability requiredOther duties as assigned by manager and / or director


Required Qualifications:High School Diploma / GED (or higher)1+ years of professional experience in an office / Customer Service environmentPrevious experience working with Microsoft Office including Microsoft Outlook (ability to create, edit, save, and send documents), Microsoft Word (ability to create, edit, save, and send documents), and Microsoft Excel (ability to create, edit, save, and send documents)Previous experience working with a computer including, but not limited to, ability to learn new computer system applicationsAbility to work a full-time schedule within department hours of Monday - Saturday (Example schedule: Tuesday - Saturday 8:30 AM - 5:30 PM)Preferred Qualifications:Bachelor's Degree (or higher)Professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties OR Customer Service experience analyzing and solving customer's problemsExperience working within the Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD-10 and CPT codes, Medicare and / or Medicaid Services, call center environmentProfessional experience in a Clerical or Administrative support related roleExperience with Lotus NotesSoft Skills:Must be a self - starter and able to work autonomouslyStrong aptitude for working in a production driven environmentAbility to work in a fast - paced, dynamic, rapidly changing environmentExcellent oral and written communication skillsAbility to multi - taskCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 where ever 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.SM 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, HI, customer service, healthcare, ICD-10, CPT codes, Medicare and/or Medicaid Services, call center environment.
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