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Clinical Administrative Coordinator – Clovis, CA

UnitedHealth Group


Location:
Clovis, CA
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1765194
Apply on the Company Site
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Job Details


Clinical Administrative Coordinator – Clovis, CA(Job Number:721929)
Description

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 17 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.
 
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.
 
Primary Responsibilities:  
  • Manage administrative intake of members or the admission / discharge information post notification
  • Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and / or providers
  • Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
  • Receive care coordination notification cases for non-clinical assessment / intervention and provide appropriate triage
  • Review requests for adverse determination, approval notification and processing notification requirements
  • Assist the clinical staff with setting up documents / triage cases for Clinical Coverage Review
  • Handle resolution / inquiries from members and / or providers that may include:
    • Benefit and Eligibility information
    • Billing and Payment issues
    • Customer material requests
    • Physician assignments
    • Authorization for treatment
    • Explanation of Benefits (EOB)
    • Verifying appropriate ICD-9 and CPT coding usage
    • Manage pending referrals
    • Checking for insurance authorization
    • Contacting Physician’s offices for required documents / Physician’s signatures
    • Updating patients and Physician’s offices regarding pending referrals
    • Assisting with obtaining any info / documents for the insurance verification process
    • Interview / intake process with patients
    • Data entry
    • Financial discussions with patients including hardship process
    • Ordering medication, informing patient of medication order
    • Providing all necessary information / documentation for the home care site for SOC

Job Clinical Admin & Processing
Primary Location US-CA-Clovis
Other Location 
Organization Optum Ops OBHomecare
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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