Positions in this function includes those responsible for initial triage of members, administrative intake of members, 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.
Applies knowledge / skills to a range of moderately complex activities.
Demonstrates great depth of knowledge / skills in own function.
Sometimes acts as a technical resource to others in own function.
Proactively identifies solutions to non - standard requests.
Solves moderately complex problems on own.
Works with team to solve complex problems.
Plans, prioritizes, organizes and completes work to meet established objectives.
May coordinate work of other team members
Required QualificationsHigh School Diploma / GED or higher
1+ years experience analyzing and solving customer problem 1+ years of healthcare or healthcare insurance experience
- Experience in a Hospital, Physician's Office or medical clinic setting
- Medical terminology
- Experience with ICD10 or CPT codes
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: Senior, CAC, UHG, Kingston, NY, Medical,
Insurance, Benefits, Medical Insurance, referrals