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Clinical Administrative Coordinator - US Remote at UnitedHealth Group

Clinical Administrative Coordinator - US Remote

UnitedHealth Group Phoenix, AZ Full-Time
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Energize your career with one ofHealthcare's fastest growing companies.  

You dream of a great career with a greatcompany - where you can make an impact and help people.  We dream of giving you the opportunity to dojust this.  And with the incrediblegrowth of our business, it's a dream that definitely can come true. Already oneof the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate ourservice centers, improve our service levels and help people lead healthierlives.  We live for the opportunity tomake a difference and right now, we are living it up.

This opportunity is with one of our mostexciting business areas: Optum - agrowing part of our family of companies that make UnitedHealth Groupa Fortune 6 leader.

Optum helps nearly 60 million Americans livetheir lives to the fullest by educating them about their symptoms, conditionsand treatments; helping them to navigate the system, finance their healthcareneeds and stay on track with their health goals. No other business touches somany lives in such a positive way. And we do it all with every action focusedon our shared values of Integrity, Compassion, Relationships, Innovation &Performance.

First point of contact for medicalmanagement activities. Receive inquiries regarding prior authorization, notification, peer to peer requests, andstatus requests. Determine requirements for authorization/notification and create acase in the applicable documentation system. Complete administrative approvals.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

You'll enjoy the flexibilityto telecommute* from anywhere within the U.S. as you take on some toughchallenges.

Training will be conductedvirtually from your home.

What we do defines who we are. Takea deeper look at how we're providing support during this global health crisisand search for a way you can get involved. View our Covid-19 Resources Page at:[ Link removed ] - Click here to apply to Clinical Administrative Coordinator - US Remote

Primary Responsibilities:

  • Respond to IncomingProvider and Enrollee calls.
  • Resolve CustomerService inquiries
  • Provide excellentCustomer Service to both Providers and Enrollees.
  • Constantly meetestablished productivity, schedule adherence, and quality standards while maintaininggood attendance.
  • ReceivesCare Coordination notification cases for non-clinical assessment/interventionand
  • providesappropriate triage
  • Processesout of network requests for consideration of in network level of benefits forphysician specialty referrals for appropriate products
  • Processesnotification requirements for outpatient procedures, home health, DME,transition of care, and network gap issues
  • Determinesbenefit coverage issues based on employer group contracts
  • Setsup/documents/triages cases for (CCR) Clinical Coverage Review
  • Ensuresall potential member needs are identified and forwarded to the appropriate CareCoordinator for risk validation when applicable
  • Processesletters within DOL time frames
  • Verifiesappropriate ICD-10 and CPT coding usage
  • Communicatesto providers and members benefit determinations within DOL time frames
  • Assist with faxesand emails.
  • Moderate workexperience within own function.
  • Some work iscompleted without established procedures.
  • Basic tasks arecompleted without review by others.
  • Supervision/guidanceis required for higher-level tasks.

You'll be rewarded andrecognized for your performance in an environment that will challenge you andgive you clear direction on what it takes to succeed in your role as well asprovide development for other roles you may be interested in.

Required Qualifications:

  • High School Diploma / GED (or higher)
  • 1+ years ofprofessional experience in an office / customer service environment
  • Proficiency inMicrosoft Word and Excel. (MS Word - Creating and editing documents, MS Excel -Creating spreadsheets and working within spreadsheets)
  • Flexibility to workoutside standard hours of operations due to changing business needs.
  • You will be required to adhere to UnitedHealth Group's USTelecommuting Policy

  • If you need to enter a work site for any reason, you will berequired to screen for symptoms using the ProtectWell mobile app,Interactive Voice Response (i.e., entering your symptoms via phone system) orsimilar UnitedHealth Group-approved symptom screener. When in a UnitedHealthGroup building, employees are required to wear a mask in common areas. In addition,employees must comply with any state and local masking orders

Telecommuting Requirements:

  • Required to have a dedicated workarea established that is separated from other living areas and providesinformation privacy
  • Ability to keep all company sensitivedocuments secure (if applicable)
  • Must live in a location that canreceive a UnitedHealth Group approved high-speed internet connection orleverage an existing high-speed internet service
Preferred Qualifications:
  • Bachelor's Degree

  • 2+ years of professional experience in an Office setting using thetelephone and computer as the primary instruments to perform the job duties OR2+ years of Customer Service experience analyzing and solving customerproblems

  • Experience working within the Healthcare Industry, Hospital,Physician's Office, or Medical Clinical setting, Medical Terminology, ICD-9 andCPT codes, Medicare and/or Medicaid Services, call center environment

  • Professional experience in a Clerical or Administrative supportrelated role

Soft Skills:
  • Ability to multi - task and to work in a fast-paced, dynamic, rapidly changing environment
  • Strong aptitude for working in a production driven environment
  • Must be a self-starter and able to work autonomously
  • Excellent oral and written communication skills

UnitedHealth Group is an essential business. Thehealth and safety of our team members is our highest priority, so we are takinga science driven approach to slowly welcome and transition some of ourworkforce back to the office with many safety protocols in place. We continueto monitor and assess before we confirm the return of each wave, payingspecific attention to geography - specific trends. At this time, 90% of our non- clinical workforce transitioned to a work at home (remote) status. We havetaken steps to ensure the safety of our 325,000 team members and theirfamilies, providing them with resources and support as they continue to servethe members, patients and customers who depend on us.

Some of the steps we've taken to ensure employee well - beinginclude:

  • Transitionedour new hire training classes to be conducted virtually
  • Launchedour ProtectWell app and UnitedCARES program to help ease the burden and stressfor our UnitedHealth Group team members and their immediate family affected byCOVID - 19
  • Dailyupdates from our CEO Dave Wichmann to support and inspire team members duringthis challenging time
  • Onsitesocial distancing and increased sanitization measures for employees who havebeen welcomed back to our offices
  • Fullycover the COVID - 19 healthcare costs for our employees
  • Employeeswho self - identify as high risk or who live with someone who is high risk havebeen asked to remain working from home

Youcan learn more about all we are doing to fight COVID - 19 and support impactedcommunities at: [ Link removed ] - Click here to apply to Clinical Administrative Coordinator - US Remote

Careers with Optum. Here's the idea. We built an entire organization around one giantobjective; make the health system work better for everyone. So when it comes tohow we use the world's large accumulation of health - related information, orguide health and lifestyle choices or manage pharmacy benefits for millions,our first goal is to leap beyond the status quo and uncover new ways to serve.Optum, part of the UnitedHealth Group family of businesses, brings togethersome of the greatest minds and most advanced ideas on where health care has togo in order to reach its fullest potential. For you, that means working on highperformance teams against sophisticated challenges that matter. Optum,incredible ideas in one incredible company and a singular opportunity to do yourlife'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, UHG, Optum, Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical, work at home, workfrom home, WAH, WFH, remote, telecommute, hiring immediately


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