Clinical Administrative Coordinator - Remote

Unitedhealth Group Shelton , CT 06484

Posted 2 months ago

Energize your career with one of Healthcare's fastest growing companies.

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

This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 10 leader.

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

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.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Training will be conducted virtually from your home.

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

Primary Responsibilities:

  • Respond to Incoming Provider and Enrollee calls

  • Resolve Customer Service inquiries

  • Provide high quality Customer Service to both Providers and Enrollees

  • Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance

  • Receive prior authorizations requests non - clinical assessment / intervention and provides appropriate triage

  • Process out of network requests for consideration of in network level of benefits

  • Process notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issues

  • Determine benefit coverage issues

  • Set up / documents / triages cases for clinical or medical director review

  • Verify appropriate ICD - 10 and CPT coding usage

  • Communicate to providers and members benefit determinations within time frames

  • Some work is completed without established procedures

  • Basic tasks are completed without review by others

  • Supervision / guidance is required for higher - level tasks

  • Other duties as assigned by manager and / or director

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

Required Qualifications:

  • High School Diploma / GED (or higher)

  • 1+ years of professional experience in an office environment OR Customer Service experience analyzing and solving customer's problems

  • Computer experience including, but not limited to, ability to learn new computer system applications

  • Experience working with Microsoft Office including Microsoft Outlook (ability to create, edit, save, and send emails), Microsoft Word (ability to create, edit, save, and send documents), and Microsoft Excel (ability to create, edit, save, and send spreadsheets)

  • Flexibility to work outside standard hours of operations due to changing business needs

  • Must have access to install secure high speed internet (minimum speed 1.5 download mps and 1 upload mps) via cable / DSL in home (NOTE: wireless / cell phone provider, satellite, microwave, etc. does NOT meet this requirement)

  • Ability to work Monday - Friday between 8am-6pm

  • Must have a designated work area established that is separated from other living areas and provides information privacy

  • Ability to keep all company sensitive documents secure (if applicable)

  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Preferred Qualifications:

  • Bachelor's Degree (or higher)
  • 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

Soft Skills:

  • Strong communication skills; Written and verbal

  • Excellent critical thinking and problem - solving skills

  • Candidate need to be highly organized with effective and exceptional communication skills

  • Strong analytical, problem solving and decision - making skills; ability to exercise good judgment

  • Ability to prioritize work, handle multiple tasks and work independently

  • Ability to trouble shoot and setup computer equipment independently

  • Ability to focus and learn in a remote setting as an independent worker

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide 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 together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM

Colorado Residents Only: The hourly range for Colorado residents is $15.00 to $25.19. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

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, Clinical, Healthcare, Administrator, UnitedHealthcare, Administrative, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #rpo

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Clinical Administrative Coordinator - Remote

Unitedhealth Group