Sign In
 [New User? Sign Up]
Mobile Version

Clinical Administrative Coordinator - Honolulu, HI

UnitedHealth Group


Location:
Honolulu, HI
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1778477
Apply on the Company Site
  •  
  • Save Ad
  • Email Friend
  • Print
  • Research Salary

Job Details


Clinical Administrative Coordinator - Honolulu, HI(Job Number:727417)
Description

Position Description:
 
Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM

Employees in this position include those responsible for initial Triage of members, Administrative Intake of members or managing the Admission / discharge information post-notification, and working with hospitals and the Clinical team. Function 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. Also manages the Referrals process, processes Incoming and Outgoing Referrals, and Prior Authorizations. This function also includes Intake, Notification and Census roles.
 

Primary Responsibilities:

  • Respond to incoming provider and enrollee calls
  • Provide excellent Customer Service to both providers and enrollees
  • Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
  • Receives Care Coordination notification cases for non-clinical assessment / intervention and provides appropriate triage
  • Processes out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate products
  • Processes notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issues
  • Processes letters within DOL time frames
  • Verifies appropriate ICD-10 and CPT coding usage
  • Communicates to providers and members benefit determinations within DOL time frames
  • Assist with faxes and emails
  • Moderate work experience within own function
  • Some work is completed without established procedures
  • Supervision / guidance is required for higher - level tasks
  • Tuesday - Saturday work schedule
  • Other duties as assigned by manager and / or director

Job Clinical Admin & Processing
Primary Location US-HI-Honolulu
Other Location 
Organization Clin Support & Notifications
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.

Powered By

Featured Jobs[ View All ]

Featured Employers [ View All ]