At UnitedHealthcare, were 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.
Clinical Administrative Coordinators (CAC) provide administrative support to Health Services teams through a variety of tasks designed to help teams promote the independence and well-being of Members while meeting State contract requirements. CACs follow identified processes, meet expected deadlines and deliver exceptional customer service.
Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles.
Youll enjoy the flexibility to telecommute* from anywhere within Michigan as you take on some tough challenges.
Primary Responsibilities
Extract and review fax requests for medical or clinical services
Receive electronic referral form requests for medical/behavioral/clinical services
Utilize phone system to respond to and transfer calls to appropriate individuals
Ask callers standard questions to understand requests, gather necessary information, and assess urgency
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
Access claims information
Review and interpret call history documentation (e.g., case notes)
Navigate between computer screens and platforms to research information (e.g., medical, clinical, or benefits information)
Reference automated job aid tools via computer to research relevant rules, regulations, or procedures
Learn computer system and process changes and updates and incorporate into daily work
Contact internal resources if necessary to clarify information
Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical request
Communicate with clinical team to ensure provider receives a response when necessary
Document call history information into relevant computer system
Enter medical request data into relevant computer system
Follow standard procedures to complete requests
Perform all 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
Youll 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 (or higher)
2+ years of customer service experience
1+ years of experience with MS Office, including Word, Excel and Outlook
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
At least 18 years of age
Preferred Qualifications
Experience supporting a Michigan Medicaid Health Plan
Experience working in team-based care
Medicare and DSNP experience
Experience working within the health care Industry and with health care insurance
Experience working in a hospital, physician’s office or medical clinic setting
A clerical or administrative support background
All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
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.
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