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Clinical Administrative Coordinator - Las Vegas, NV more...
Location:Las Vegas (Las Vegas Business Reply), NV
Company:Optum Operations
First posted:June 01, 2017

Position Description: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 17 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

Talk about meaningful work.Talk about an important role. Let's talk about your next career move. Due to our expanding business, Optum is seekingClinical Administrative Coordinatorswho share our passion for helping others live healthier lives. As one of the world's leading health care companies, Optum 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 Optum? 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.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.Primary Responsibilities:

Manage the intake of members or the admission / discharge information post notification
Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and / or providers
Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
Provide appropriate triage and care coordination notification cases for non-clinical assessment / intervention
Process notification requirements
Assist the clinical staff with setting up documents / triage cases for Clinical Coverage Review
Handle resolution / inquiries from members and / or providers that may include:

Benefit and Eligibility information
Billing and Payment issues
Customer material requests
Physician assignments
Authorization for treatment
Explanation of Benefits (EOB)
Verifying appropriate ICD-10 and CPT coding usage
Extensive work experience within own function
Work is frequently completed without established procedures
Works independently
May act as a resource for others
May coordinate others activities

Required Qualifications:

High School Diploma or GED
1+ years of customer service experience analyzing and solving customer problems
1+ years of call center experience
2+ years of experience working within the Healthcare Industry
1+ years of experience working with Healthcare Insurance
Must be able to navigate a PC to open applications, send emails, and conduct data entry
Working knowledge of Medical Terminology to communicate with members and providers
Preferred Qualifications:

Experience working in a Hospital, Physician's Office, or Medical Clinical setting
Professional experience in a clerical or administrative support related role
Experience working with ICD-9, ICD-10 and CPT codes
Experience working with Medicare and / or Medicaid Services

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.
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, Nevada, Call Center, Clinical, Healthcare

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