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Medical Claims Review Coordinator for WellMed - San Antonio, TX

UnitedHealth Group

San Antonio, TX
Job Code:
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Job Details

Medical Claims Review Coordinator for WellMed - San Antonio, TX(Job Number:709714)

The hours for this position are Monday - Friday 9am to 6pm.  There will be some occasional overtime as needed on Saturdays.
WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient’s health.  WellMed’s proactive approach focuses on prevention and the complete coordination of care for patients.  WellMed is now part of the Optum  division under the greater UnitedHealth Group umbrella.
Do you have compassion and a passion to help others?  Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
Start your healthcare career with WellMed!
Great entry level position in healthcare!  In this position you will interact with patients and their  family members, healthcare providers,  insurance companies.  Learn from healthcare experts as you work side by side to improve the lives of patients!  Enjoy profound job satisfaction as you impact the care and comfort of our aging population.  We offer  the benefits of working for a large, multi-national company – career opportunities, great benefits, paid time off, and more!   The successful candidate will demonstrate effective customer service and communication skills. 
Primary Responsibilities:           
  • Answering incoming calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
  • Analyze and apply denials
  • Process and Review Claims
  • Excellent Data Entry Skills needed
  • Experience in Contract Interpretation
  • Medical Insurance Industry processing
  • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
  • Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member / provider
  • Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
  • Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
  • Analyze and identify trends and provides reports as necessary
  • Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance
  • Ability to work on various other projects as needed

Job Patient Services
Primary Location US-TX-San Antonio
Other Location 
Organization WellMed Medical Mgmt, Inc
Schedule Full-time
Number of Openings 2
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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