Energize your career with one of Healthcares 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, its a dream that definitely can come true. Already one of the worlds 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 14 leader.
The Call Center LPN is responsible for assisting members, providers, and clinicians Cared for by Care Services (HouseCalls and Complex Care Management) Advanced Practice Clinicians (APCs). All work is performed in a clinical call center environment.
Resolving concerns for members, providers, and APCs, triaging to the appropriate discipline when necessary (Dietitian, Nurse Care Manager, Pharmacist, Social Worker).
Enhance the experience of both internal and external customers by providing excellent customer service.
Serve as a bridge between healthcare providers and members to answer questions / address concerns related to member care.
Retrieve and respond to voicemail messages, triaging as need.
Call members and / or providers with laboratory and / or test results as needed.
Access health plan portals to verify benefit eligibility / benefits for patients and seek additional information as necessary
Obtains medical records when requested by a provider
Perform data entry and complete documentation of calls.
Perform data entry into electronic medical record (EMR) utilizing information from an electronic or hardcopy source (referred to as the ISNP Backfilling process)
Input / update patient demographic (address, phone number, PVP, PCP, NCM, etc) and healthcare data (medical records, lab / HEDIS results) into EMR and computer database systems.
Enter internal referrals to Social Work, Dietitians and Case Managers and locate community resources for members as directed by providers.
Uploads Informed Consent, ROI, POA, and other documents as necessary into EMR
Enter / process / track patient referral data (e.g., medical services, radiology, durable medical equipment, lab orders, specialist referrals) and follow up until completion.
Completes Manual Hospitalization Tracker and other reports per market specifications
Generate reports on patient data through relevant computer systems / applications
Review / analyze patient data reports (e.g., discharges, hospital admissions / read missions, skilled nursing facilities) and follow up as necessary
Draft / provide written communications to patients (e.g., standard letters, welcome letters, educational materials, authorization forms) in compliance with company and health plan guidelines.
Process direct referrals from health plan and schedule members for initial visit with provider.
Participate in weekly care conference calls with market / weekly market meetings as needed.
Manage internal health plan mailboxes / task boxes in the EMR.
Ensures PCP communication via auto fax or manual fax of visit notes.
Demonstrate understanding of Federal privacy regulations (e.g., HIPPA) and safety guidelines / practices (e.g., OSHA)
Ensure that all phone interactions meet quality standards set by the department.
Participate in and contribute to staff meetings and other staff development opportunities and interdepartmental work groups.
Work with Supervisor to identify system improvements that could be made to drive operational advancements and efficiencies.
Other duties as assigned by Supervisor or Manager.
**Please note that we work across different time zones and this position will be day shift position but exact times will depend on the market/program assigned**
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.