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UnitedHealth Group Clinical Administrative Coordinator- Telecommute within MST or PST in Phoenix, Arizona

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 6 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.

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.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (8:30am - 6:00pmMST or PST). It may be necessary, given the business need, to work occasional overtime.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

We offer 2 weeks of paid training. The hours during training will during core business hours.

Training will be conducted virtually from your home.

What we do defines who we are. Take a deeper look at how we're providing support during this global health crisis and search for a way you can get involved. View our Covid-19 Resources Page at: https://info.uhg.com/

Primary Responsibilities:

  • Receive cases regarding prior authorization, and or notification

  • Complete administrative approvals and prep cases for RN/RMD review with DOL time frames

  • Respond to incoming provider and enrollee calls

  • Determine if the consumers are eligible for a health program

  • Connect consumers to a nurse

  • Take calls from providers and enter services that they are requesting into the system

  • Must have accurate documentation and strong attention to detail

  • Must meet weekly metrics

  • 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, and, network gap issues

  • Determines benefit coverage issues based on employer group contracts

  • Sets up/documents/triages cases for (CCR) Clinical Review

  • 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

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.

  • Must be able to work Monday- Friday 8:30am-6:00pmMST or PST

  • 2+ years of experience working in the healthcare industry and working knowledge of medical terminology

  • 2+ year of customer service experience analyzing and solving customer problems

  • 1+ year of experience with medical terminology working with ICD-9 / 10 and CPT codes

  • 2+ years of customer service experience in a call center environment

  • 2+ years experience working with Microsoft Word (creating, editing, saving documents) and Microsoft Excel (creating, editing, saving spreadsheets)

  • 2+ years experience working with a PC and windows applications, with the ability to learn other sometimes complex systems

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

Preferred Qualifications:

  • 2+ years of professional experience in an Office setting using the telephone and computer as the primary instruments to perform the job duties

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

Telecommuting Requirements:

  • Required to have a dedicated 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

Soft Skills:

  • 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

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

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

  • Transitioned our new hire training classes to be conducted virtually

  • Launched our ProtectWell app and UnitedCARES program to help ease the burden and stress for our UnitedHealth Group team members and their immediate family affected by COVID-19

  • Daily updates from our CEO Dave Wichmann to support and inspire team members during this challenging time

  • Onsite social distancing and increased sanitization measures for employees who have been welcomed back to our offices

  • Fully cover the COVID-19 healthcare costs for our employees

  • Employees who self-identify as high risk or who live with someone who is high risk have been asked to remain working from home

  • You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

Join us today and we can provide you with meaningful challenge that can result in a strong sense of impact and fulfillment. It's truly an opportunity to do your life's best work.SM

UnitedHealth 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: customer service, healthcare, telephonic, patient interaction, field based, advocacy, medical terminology, codes, coding, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately

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