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Authorization Coordinator - Phoenix, AZ

UnitedHealth Group


Location:
Phoenix, AZ
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1784763
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Job Details


Authorization Coordinator - Phoenix, AZ(Job Number:729226)
Description

Position Description:

Healthcare isn’t just changing. It’s growing more complex every day. ICD-10 Coding replaces ICD-9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that’s what fueled these exciting new opportunities.

Who are we? Optum360. We’re a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.

If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.


The Authorization Coordinator is responsible for ensuring a positive experience throughout the authorization process while employing excellent customer service skills.

 

Primary Responsibilities:
  • Facilitate communication between the hospital facilities and the payers.
  • Fulfilling payer requests for clinical reviews and Medical Record.
  • Becoming knowledgeable of payer assigned time frames.
  • Understanding specific payer Utilization Management details.
  • Collaborating and alerting facility Case Managers of:
    • Additional payer needs
    • Requests for concurrent or retrospective review
    • Physician Advisor review
  • Providing support in the certification process to ensure timely authorization of inpatient days followed by timely and accurate documentation.
  • Facilitating the scanning, copying, and mailing of documents for deferred cases or for cases involved in a concurrent clinical appeal.
  • Tracking Medicaid / Medi-Cal cases to ensure timely receipt of any concurrent appeal decision by the payer.
  • Monitoring payer and State portals and websites for documents related to commercial certification, Treatment Authorization Request (TARs), and Service Authorization Request (SARs)
  • Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Optum360’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
  • Other duties as needed and assigned by their Manager, Director and or Senior Director

Job Patient Services
Primary Location US-AZ-Phoenix
Other Location 
Organization O360 Dignity Health Front Ops
Schedule Full-time
Number of Openings 2
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UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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