This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.
Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission / discharge information post - notification, working with hospitals and the clinical team. 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. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. *Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.
- Manage administrative intake of members
- Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and / or providers
- Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
- Assist the clinical staff with setting up documents / triage cases for Clinical Coverage Review
- Handle resolution / inquiries from members and / or providers
- Moderate work experience within own functionSome work is completed without established procedures.
- Basic tasks are completed without review by others.
- Supervision / guidance is required for higher level tasks.
- HS Diploma or GED (or higher)
- 2+ years of customer service experience
- Experience with MS Word, MS Excel and MS Outlook with the ability to edit, create, save and send spreadsheets and documents
- Experience working within the health care Industry and with health care insurance
- Experience working in a hospital, physician's office or medical clinic setting
- A clerical or administrative support background
- Knowledge of ICD -10 and CPT codes
- Experience working in a call center
- Workers Compensation experience
- Bilingual in English and Spanish
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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: clinical, administrative, coordinator