Clinical Administrative Coordinator - Telecommute in Phoenix, AZ area(Job Number:705679)
Position Description: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.
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.
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.
This is a Telecommute opportunity in the Phoenix, AZ area. Candidate will be required to come into the Phoenix office for training and meetings.
- Respond to Incoming Provider and Enrollee calls
- Resolve Customer Service inquiries
- 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
- Determines benefit coverage issues based on employer group contracts
- Sets up/documents/triages cases for (CCR) Clinical Coverage Review
- Ensures all potential member needs are identified and forwarded to the appropriate Care Coordinator for risk validation when applicable
- 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
- Basic tasks are completed without review by others
- Supervision/guidance is required for higher-level tasks
- Other duties as assigned by manager and/or director
Job Clinical Admin & Processing
Primary Location US-AZ-Phoenix
Organization Clin Support & Notifications
Number of Openings 3