Part of the challenge here is dealing positively with members and providers in sometimes challenging circumstances. As a subject matter expert, you'll also be the go - to - resource for information. The flexibility to work evening hours will also be required.
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.
- Act as a Subject Matter Expert for other team members
- Manage the intake of members or the admission / discharge information post notification
- Work with hospitals, clinics, facilities and the clinical team to manage requests for services
- Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
- Resolve inquiries from members and / or providers
- Extensive work experience within own function
- Work is frequently completed without established procedures
- Works independently
- May act as a resource for others
- May coordinate others' activities
- High School Diploma / GED or higher
- 2+ years experience analyzing and solving customer problems
- 2+ years of experience working in the health care industry
- 6+ months of experience working with medical terminology
- Administrative skills experience in a hospital, physician's office or medical clinic setting
- Experience working with health care insurance
- Clerical or administrative support background or experience working in a call center environment
- Experience working with Medicare and / or Medicaid Services
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, clinical, administrative, coordinator