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Contract

Clinical Administrative Coordinator – Bend, OR

Position Description: Talk about meaningful work. Talk about an important role. Let’s talk about your next career move. Due to our expanding business, UnitedHealth Group is seeking Clinical Administrative Coordinators who share our passion for helping others live healthier lives. As one of the world’s leading health care companies, UnitedHealth Group is pursuing innovative new ways to operate our service centers and improve on our ability to deliver high-quality care. 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 for our members and providers. You’ll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you’ll have the opportunity to make an impact on a huge scale. Take this opportunity and begin doing your life’s best work. (sm) What makes your clinical career greater with UnitedHealth Group? You’ll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you’ll open doors for yourself that simply do not exist in any other organization, anywhere.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.Primary Responsibilities: Gathers patient information accurately and completely by utilizing appropriate templates in CPR+.Verifies insurance eligibility prior to processing order.Assembles patients electronic medical record accurately and completely and manages documents appropriately in CPR+.Process orders in a timely manner.Obtains necessary information according to Joint Commission (JCAHO) guidelines.Obtains authorization for services.Informs Clinical Teams of referrals and updates them on the status of the case.Prepares pending files by utilizing appropriate templates in CPR+Communicates/Coordinates referrals with outside pharmacies and referral sourcesUnderstands diversity of contracts to handle referrals accordingly.Coordinates the start of care with the patient/caregiver, referral source, and other providers of care.Coordinates time and initial delivery.Cancels pending/no-go referrals when appropriate.Documents patient related activities/information in the patients electronic medical record.Consults with direct Manager on difficult or unusual referrals, as appropriate.Maintains confidentiality of patient and company information.Complies with all company policies and procedures.Gathers and ensures all necessary documentation for chart is obtained.Communicates effectively with Clinical Team members to assure a smooth transition from intake to start of care.Monitor MY Fax for incoming information and printing information.Check electronic discharge websites for new referrals and updated information, as required.Send the initial referral email to sales/onsite to confirm receipt of the referral.Formulate and negotiate private pay pricing as per limitations set by company.Scans and appropriately label patient documents in CPR+.Performs other duties as required.Moderate work experience within own function.Some work is completed without established procedures.Basic tasks are completed without review by others.Supervision/guidance is required for higher level tasks. Requirements: HS Diploma or GED2+ years of customer service experience analyzing and solving customer problemsMust be able to create, edit, save and send documents utilizing Microsoft Word and ExcelMust be able to navigate a PC to open applications, send emails, and conduct data entryPreferred Qualifications: Experience working within the Healthcare IndustryExperience working with Healthcare InsuranceExperience working in a Hospital, Physician’s Office, or Medical Clinical setting.Professional experience in a clerical or administrative support related roleWorking Knowledge of Medical Terminology to communicate with members and providersExperience working with ICD-9 and CPT codesExperience working with Medicare and/or Medicaid ServicesUnitedHealth Group is working to create the health care system of tomorrow. Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we’re doing a lot of good.Through our family of businesses and a lot of inspired individuals, we’re building a high-performance health care system that works better for more people in more ways than ever. Now we’re looking to reinforce our team with people who are decisive, brilliant and built for speed.Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.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: Insurance, customer services, customer services representative, claims, appeals, call center, phone support, dispute resolution, healthcare, UnitedHealth Group

Company: UnitedHealth Group

Date: Tue, 20 Dec 2016

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