Clinical Administrative Coordinator - Fresno, CA

Company: UnitedHealth Group
Location: Fresno
Posted on: December 5, 2019

Job Description:

E nergize your career with one of Healthcare’s 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, it’s a dream that definitely can come true. Already one of the world’s 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 6 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, 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. (sm) Primary Responsibilities: Manage administrative 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 Receive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triage. Review requests for adverse determination, approval notification and processing notification requirements Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review Handle resolution / inquiries from members and/or providers Benefit and Eligibility information Billing and Payment issues Customer material requests Physician assignments Authorization for treatment Explanation of Benefits ( EOB ) Verifying appropriate ICD - 9 and CPT coding usage 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 (or higher) 2+ years of customer service experience analyzing and solving customer problems Ability to create, edit, save and send documents and spreadsheets utilizing Microsoft Word and Microsoft Excel Ability to navigate a PC to open applications, send emails, and conduct data entry P referred Qualifications: Experience working within the Healthcare Industry Experience working with Healthcare Insurance Experience working in a Hospital, Physician's Office, or Medical Clinical setting. Professional experience in a clerical or administrative support related role Working Knowledge of Medical Terminology to communicate with members and providers Experience working with ICD - 9 and CPT codes Experience working with Medicare and / or Medicaid Services Experience working in a call center environment 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.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: Clinical Admin, Fresno, California, CA, Administration

Keywords: UnitedHealth Group, Fresno , Clinical Administrative Coordinator - Fresno, CA, Other , Fresno, California