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Clinical Administrative Coordinator - US Telecommute

10/01/2018Call Center
Job Location:
Shelton, CT
Metro Area:
NY - New York City
Company Name: UnitedHealth Group
Website:  Click to Visit
UnitedHealth Group
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:Respond to Incoming Provider and Enrollee callsResolve Customer Service inquiries Provide excellent Customer Service to both Providers and EnrolleesMeet established productivity, schedule adherence, and quality standards while maintaining good attendanceReceive Care Coordination notification cases for non-clinical assessment / intervention and provides appropriate triageProcess out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate productsProcess notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issuesDetermine benefit coverage issues based on employer group contractsSets up / document / triage cases for (CCR) Clinical Coverage ReviewEnsure all potential member needs are identified and forwarded to the appropriate Care Coordinator for risk validation when applicableProcess letters within DOL time framesVerify appropriate ICD-10 and CPT coding usageCommunicate to providers and members benefit determinations within DOL time framesAssist with faxes and emailsModerate work experience within own functionSome work is completed without established proceduresBasic tasks are completed without review by othersSupervision / guidance is required for higher-level tasksOther 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 Healthcare experiencePrevious experience working with Microsoft Outlook, Microsoft Word, and Microsoft Excel (ability to create, edit, save and send)Computer experience including, but not limited to, ability to learn new computer system applicationsAbility to work Tuesday - Saturday, Sunday - Thursday, or Monday - Friday between 8:00 am - 6:00 pm Flexibility to work outside standard hours of operations due to changing business needsMust have a quiet designated work space and access to install secure high speed internet (minimum speed 1.5 download mps and 1 upload mps) via cable / DSL in home (NOTE: wireless/cell phone provider, satellite, microwave, etc...does NOT meet this requirement)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 problemsExperience working within a 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 roleBilingual fluency in English and SpanishCareers 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.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, Clinical, Healthcare, Administrator, UnitedHealthcare
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