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.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.Under the manager direction, functions as a Clinical Administrative Coordinator in the Utilization Management department. Primarily responsible for initiation of cases by data entry of clinical into the Facets system, via telephone, fax or computer. Electronically routes cases to the nurse for review and decision. After decision, is responsible for accurate case completion to include generation of approval letters while staying within compliance with time frames. Communicates with providers other departments as needed. Works independently with minimal supervision.Primary Responsibilities:Process admission notifications; enter cases into Facets and ACM, fax logs to clinical team and file documents.Data entry of census updates and discharged cases; includes entry of correct dates, room type codes, discharge disposition and status; filing of documents. Performs responsibilities per the Master Schedule, including but not limited to running the Meditech census, discharges exception report, Access Center Call Log, and Transportation Log.Run admissions and discharge reports from Meditech / HCA system.Process newborn enrollment forms upon notification.Verify insurance eligibility; build case under correct member; flag cases for COB potential.Works with clinical teams to problem solve routine issues related to inpatient and skilled nursing facility cases.Maintains accuracy rating of 98% or better on all cases.
Required Qualifications:High School Diploma / GED or higher Must be flexible to work any day of the week Monday - Sunday, including some holidays and must be able to work any shift between 4:00 AM - 6:00 PM.2+ years of experience working in a healthcare facility, Hospital, Physician's Office, or Managed Care settingPrevious experience with Medical TerminologyPrevious experience working with ICD - 10 and CPT codesAbility to utilize Microsoft Word, Microsoft Excel, and Microsoft OutlookAbility to navigate a PC and open applicationsInsurance Verification and Eligibility experience.Preferred Qualifications:Prior Authorization experienceCall Center experienceCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life'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: UHG, Las Vegas, customer service, healthcare, telephonic, patient interaction, field based, advocacy
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.