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- Honolulu, HI
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Clinical Administrative Coordinator - Honolulu, HI
UnitedHealth Group • Honolulu, HI
Posted 21 days ago
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Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.
- Respond to incoming provider and enrollee calls
- Provide excellent Customer Service to both providers and enrollees
- Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
- 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
- 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
- Assist with faxes and emails
- Moderate work experience within own function
- Some work is completed without established procedures
- Supervision / guidance is required for higher - level tasks
- Full-time schedule: Monday - Saturday availability required
- Other duties as assigned by manager and / or director
- High School Diploma / GED (or higher)
- 1+ years of professional experience in an office / Customer Service environment
- Previous experience working with Microsoft Office including Microsoft Outlook (ability to create, edit, save, and send documents), Microsoft Word (ability to create, edit, save, and send documents), and Microsoft Excel (ability to create, edit, save, and send documents)
- Previous experience working with a computer including, but not limited to, ability to learn new computer system applications
- Ability to work a full-time schedule within department hours of Tuesday - Saturday 8:30 am - 5:30 pm
- Bachelor's Degree (or higher)
- Professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties OR Customer Service experience analyzing and solving customer's problems
- Experience working within the Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD-10 and CPT codes, Medicare and / or Medicaid Services, call center environment
- Professional experience in a Clerical or Administrative support related role
- Experience with Lotus Notes
- Must be a self - starter and able to work autonomously
- Strong aptitude for working in a production driven environment
- Ability to work in a fast - paced, dynamic, rapidly changing environment
- Excellent oral and written communication skills
- Ability to multi - task
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, Honolulu, HI, customer service, healthcare, ICD-10, CPT codes, Medicare and/or Medicaid Services, call center environment