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Our Customer Service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care. You will be assigned to do waiver service plans that will contain data collected from Care Managers. You will be asked, at times, to take phone calls from Members. These calls will be inquiries about benefits coverage. You will also be asked, at times, to enter expense reports into the system.
Positions in this function include a more traditional Clinical Administrative Coordinator role by: answering the telephone, typing / word processing of documents, maintaining calendars and setting up meetings, making travel arrangements, copying, faxing, greeting visitors, setting up files, tracking expenses, coordinating building and equipment maintenance. You will learn to assist with the On - boarding of new staff. As well as supporting the Managers and the Clinical Care Managers in the field. This includes ordering supplies, data entry and troubleshooting computer issues. At senior levels, function may include supervision of other clerical / administrative staff. Duties will include administrative intake of members or managing the admission / discharge information post - notification, working with hospitals and the clinical team. Manage the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. Provide excellent Customer Service to both Providers and Enrollees.
Extract and review fax requests for medical or clinical services
Access electronic member files using policy or id number
Determine member eligibility
Follow protocols to task requests appropriately
Check procedure codes against notification requirements and benefit coverage to determine next steps
Reference automated job aid tools via the computer to identify appropriate procedures when needed
Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
Maintain Confidentiality and adhere to HIPAA requirements
Ability to sustain concentration to enter waivers for extended periods of time
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.