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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Medical and Clinical Operations

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Senior Clinical Administrative Coordinator - Phoenix, AZ

UHG - Phoenix, Arizona

Posted: 12/13/2018

Let's face it, no industry is moving faster than health care. And no organization is better positioned to move health care forward than UnitedHealth Group. We're out to use data, technology and people in ways that help drive change and make the health care system work better for everyone. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive. Take this opportunity to work with a Fortune 6 industry leader.


Primary Responsibilities:


  • Receives Care Coordination notification cases for non - clinical assessment / intervention and provides appropriate triage
  • Processes out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate products
  • Processes notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issues
  • Determines benefit coverage issues based on employer group contracts
  • Sets up / documents / triages cases for (CCR) Clinical Coverage Review
  • Ensures all potential member needs are identified and forwarded to the appropriate Care Coordinator for risk validation when applicable
  • Processes letters within DOL time frames
  • Verifies appropriate ICD - 10 and CPT coding usage
  • Communicates to providers and members benefit determinations within DOL time frames
  • Other duties as assigned by manager and / or director

Requirements:

  • High School Diploma / GED or higher
  • 2+ years of experience working in the healthcare industry
  • 2+ year of customer service experience analyzing and solving customer problems
  • 6+ months of insurance experience
  • 1+ year of experience with medical terminology
  • Available to work 40 hours per week anytime within the operating hours of the site
  • Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system application and apply their use for phone and off phone

Preferred Qualifications:

  • ICD - 10 and CPT coding knowledge
  • Working knowledge of benefit design and interpretation

Soft skills:

  • Ability to multi - task, this includes ability to understand multiple products and multiple levels of benefits within each product
  • Ability to remain focused and productive each day though tasks may be repetitive
  • Capable of working in a complex, fast paced, dynamic environment that involves multiple customer types, products and evolving systems
  • Ability to work autonomously - must be a self - starter
  • Ability to work in a rapidly changing environment - adaptable, flexible
  • Excellent oral and written communication skills
Your confidence, decisiveness and perseverance will help you positively impact our patient lives. It's an opportunity to do your life's best work.SM

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do 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: UHG, UnitedHealth Group, Senior, Clinical Administrative, Coordinator, Phoenix, AZ

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