Clinical Administrative Coordinator - Remote in New Jersey
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Clinical Administrative Coordinator will be responsible for managing administrative intake of members using ICUE and Community Care, working with hospitals, clinics, facilities, and the clinical team to manage requests for services from members and / or providers. Process incoming and outgoing referrals, and prior authorizations, including intake, notification, and census roles. Assist the clinical staff with administrative task and member / provider correspondence. Handle inbound calls (20-30 daily) for resolution / inquiries from members and / or providers. This position is full - time (40 hours / week), Monday - Friday. Employees are required to work our normal business hours of 8:30 AM - 5:00 PM (Eastern Standard Time zone) from Monday - Friday including the flexibility to work occasional overtime based on business need. We offer 2 weeks of training. Training will be conducted virtually from your home. Travel is 0-10% for quarterly meetings at the East Brunswick, NJ office. If you reside within the state of New Jersey, you will enjoy the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities:
- Managing administrative intake of members
- Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
- Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
- Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
- Handle resolution/inquiries from members and/or providers
- Extract and review of fax requests for medical or clinical services, and ensure that these requests are assigned to the correct individual(s)
- Access electronic member files using policy or id number
- Determine member eligibility
- Provide support to field staff in locating providers who can assist our members. This will include calling/ emailing / faxing multiple providers
- Mail member materials, including care plans, and open, sort and distribute incoming correspondence via hard copy or e-mail
- Fax care plans to providers on the members' care team
- Follow protocols to task requests appropriately
- Reference automated job aid tools via the computer to identify appropriate procedures when needed
- Consistently meet established productivity, schedule adherence, and quality standards while maintaining good attendance
- Maintain Confidentiality and adhere to HIPAA Requirements
- Heavy calls
- Performs other duties as assigned
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
- More information can be downloaded at: http://uhg.hr/uhgbenefits
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
- 2+ years of customer service experience working within the healthcare industry and with healthcare insurance
- Intermediate level of experience in working with Microsoft Office, including Microsoft Word (ability to create, edit, save, and send documents), Microsoft Excel (ability to create, edit, save, and send spreadsheets), Microsoft PowerPoi