Clinical Administrative Coordinator - Remote in MST or CST
If you are located within Mountain and Central Time Zone, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Under the supervision of the Network Operations Supervisor, this position is responsible for the daily coordination of Network Operations processes in the Intake Call Center. This position serves as the initial intake of pre-service requests, claim reviews, inpatient hospital coordination, and diabetic supplies. Coordinates Network Operations processes with Medical Directors, Network Operations Nurses, hospitals, physicians, and other various departments. Provides clerical support to clinical staff in their medical necessity review process. The Intake Coordinator is expected to maintain production and quality standards.
This position is full-time (40 hours/week), Sunday - Saturday between 9:00am - 7:00pm CST with variable shifts to support our 24-hour operations. Employees must be able to work any shift in a 24-hour period, all days of the week, including weekends and/or evening and overnight shifts.
We offer 6-8 weeks of paid training. The hours during training will be 8:00am to 4:30pm CST, Monday - Friday.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Primary Responsibilities:
- Managing authorizations/notifications and other service requests received via incoming phone calls, faxes, and portal submission.
- Providing excellent customer service, including the ability to handle escalated callers.
- Determining authorization or notification requirements.
- Preparing authorization cases for Medical Directors, Network Operations Nurses, and Case Managers.
- Providing administrative approvals (depends on the line of business).
- Handling expedited authorizations, authorization updates, and status checks.
- Outreaches to providers and/or patients to complete authorization requests and prescriptions.
- Maintaining knowledge of various health plan partner benefits, networks, CMS regulations, and health plan partner policies.
- Utilizing experience and judgment to plan, accomplish goals, and effectively resolve each assigned task.
- Non-Clinical staff is not responsible for conducting any Network Operations activity that requires interpretation of clinical information.
- Performs all other related duties as assigned.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- High School Diploma / GED.
- Must be 18 years of age or older.
- 1+ years of combined or related experience in a healthcare, call center, and/or customer service setting using the telephone and computer as the primary instrument to perform job duties.
- Proficiency with Microsoft Office Word (create and maintain documents), Excel (create and maintain spreadsheets), and Outlook (email and calendaring).
- Ability to work Sunday - Saturday between 9:00am - 7:00pm CST with variable shifts to support our 24-hour operations.
Preferred Qualifications:
- Medical Terminology.
- ICD-10 and CPT Knowledge.
Telecommuting Requirements:
- Reside within MST or CST (but must work on Central Time Zone).
- Ability to keep all company sensitive documents secure (if applicable).
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage existing high-speed internet service.
Colorado Residents Only: The hourly range for this is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life.
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.
#J-18808-Ljbffr
