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. This is high volume, customer service
environment. You'll need to be efficient, productive and thorough
dealing with our members over the phone. You also must be able to work a
flexible schedule that includes evening hours. Positions in
this function includes those responsible for initial triage of members,
administrative intake of members or managing the admission / discharge
information post - notification, working with hospitals and the clinical
team. 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.
Manages the referrals process, processes incoming and outgoing
referrals, and prior authorizations. This function includes intake,
notification and census roles. *Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.Primary Responsibilities:
Manage administrative intake of members Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and / or providersProcess incoming and outgoing referrals, and prior authorizations, including intake, notification and census rolesAssist the clinical staff with setting up documents / triage cases for Clinical Coverage ReviewHandle resolution / inquiries from members and / or providers Moderate work experience within own functionSome work is completed without established procedures.Basic tasks are completed without review by others.Supervision / guidance is required for higher level tasks.
Required Qualifications:HS Diploma or GED (or higher)2+ years of customer service experience Experience with MS Word, MS Excel and MS Outlook with the ability to edit, create, save and send spreadsheets and documents
Preferred Qualifications:Experience working within the health care Industry and with health care insuranceExperience working in a hospital, physician's office or medical clinic settingA clerical or administrative support backgroundKnowledge of ICD -10 and CPT codesExperience working in a call center Workers Compensation experienceBilingual in English and Spanish
Join us today and we can provide you with meaningful challenge that can result in a strong sense of impact and fulfillment. It's truly an opportunity to do your life's best work.SM Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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: clinical, administrative, coordinator