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Healthcare Services Coordinator - Field Based - Raleigh, NC

UnitedHealth Group

Raleigh, NC
Job Code:
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Job Details

742023 Healthcare Services Coordinator Field Based Raleigh NC

Healthcare Services Coordinator - Field Based - Raleigh, NC (742023)

Position 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 6 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.

Primary Responsibilities:
  • Assisting in the review of medical records to highlight Star opportunities for the medical staff
  • Partner with your leadership team, the practice administrative or clinical staff to determine best strategies to support the practice and our members
  • Assist members in navigating their network of providers by assisting with follow-up and specialist appointments as needed
  • Assist with program eligibility and appropriate referrals to remove barriers in care
  • This may include referrals to case management and/or social worker services
  • Interaction with UHC members via telephone to assist and support an appropriate level of care
  • This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities
  • Answer inbound calls from patients and/or providers regarding appointments
  • Communicate scheduling challenges or trends that may negatively impact quality outcomes
  • Activities may include data collection, data entry, quality monitoring, HQPAF submission and chart collection activities
  • Track appointments and document information completely and accurately in all currently supported systems in a timely manner
  • Demonstrate sensitivity to issues and show proactive behavior in addressing customer needs
  • Provide ongoing support and education to team members and assist in removing barriers in care
  • Optimize customer satisfaction, positively impact the closing of gaps in care and productivity
  • Locate medical screening results / documentation to ensure quality measures are followed in the closure of gaps
  • Will not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and / or certified staff
  • Manage time effectively to ensure productivity goals are met
  • Ability to work independently in virtual setting. Ability to problem solve, use best professional judgment and critical thinking techniques to resolve issues as they arise
  • Identify and seek out opportunities within one’s own work flow to improve call efficiency
  • Adhere to corporate requirements related to industry regulations / responsibilities
  • Maintain confidentiality and adhere to HIPAA requirements


Required Qualifications:
  • High School Diploma / GED or higher 
  • 2+ years of telephonic customer service experience
  • 1+ years of experience in a healthcare background with medical terminology familiarity of clinical issues
  • 1+ years of working experience with ICD- 9/10 and CPT Codes
  • 1+ years of working experience with Microsoft Word and Outlook
  • 1+ years of working experience with and knowledge of HIPAA compliance requirements
  • Experience with navigating, filtering and analyzing reports in Microsoft Excel
  • Strong data entry skills, with a typing speed of at least 45-50 WPM
  • Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated area
  • Must reside within a 60 mile radius from Raleigh, NC
Preferred Qualifications:
  • Bilingual in English and Spanish
  • Experience working in a Physician's, Provider's, and / or Medical Office
  • EMR (Electronic Medical Records) knowledge and experience
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM

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: Field based, customer services, customer services representative, claims, appeals, call center, phone support, dispute resolution, healthcare, UnitedHealth Group

Job Details

  • Contest Number742023
  • Job TitleHealthcare Services Coordinator - Field Based - Raleigh, NC
  • Job FamilyMedical and Clinical Operations
  • Business SegmentOptumInsight

Job Location Information

  • Raleigh, NC
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusNon-exempt

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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