Job Description

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing

your lifes best work.

Talk about meaningful work. Talk about an important role. Lets talk about your next career move. Due to our expanding business,

UnitedHealth Groupis seeking

Clinical Administrative Coordinatorswho share our passion for helping others live healthier lives. As one of the worlds leading health care companies,

UnitedHealth Groupis 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. Youll 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 youll have the opportunity to make an impact on a huge scale. Take this opportunity and begin doing

your lifes best work.

What makes your clinical career greater with

UnitedHealth GroupYoull work within an incredible team culture a clinical and business collaboration that is learning and evolving every day. And, when you contribute, youll open doors for yourself that simply do not exist in any other organization, anywhere.
This position is full-time (40 hours/week) Monday – Friday. Employees are required to work our normal business hours of 8:00am – 6:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
* All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

Primary Responsibilities

Respond to Incoming Provider and Enrollee calls
Resolve Customer Service inquiries
Provide excellent Customer Service to both Providers and Enrollees
Meet established productivity, schedule adherence, and quality standards while maintaining good attendance
Receive Care Coordination notification cases for non – clinical assessment / intervention and provides appropriate triage
Process out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate products
Process notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issues
Determine benefit coverage issues based on employer group contracts
Set up / document / triage cases for (CCR) Clinical Coverage Review
Ensure all potential member needs are identified and forwarded to the appropriate Care Coordinator for risk validation when applicable
Process letters within DOL time frames
Verify appropriate ICD – 10 and CPT coding usage
Communicate to providers and members benefit determinations within DOL time frames
Assist with faxes and emails
Moderate work experience within own function
Some work is completed without established procedures
Basic tasks are completed without review by others
Supervision / guidance is required for higher – level tasks
Other duties as assigned by manager and / or director

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)
Healthcare experience
1 years of professional experience in an office / customer service environment
Experience working with Microsoft Outlook, Microsoft Word, and Microsoft Excel (ability to create, edit, save and send emails, documents and spreadsheets)
Computer experience including, but not limited to, ability to learn new computer system applications
Ability to work full-time (40 hours / week) Tuesday – Saturday, Sunday – Thursday, or Monday – Friday between 8:00 am – 6:00 pm
Flexibility to work outside standard hours of operations due to changing business needs
If you need to enter a work site for any reason, you will be

requiredto screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking ordersPreferred Qualifications

Bachelors Degree (or higher)
Professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties OR customer service experience analyzing and solving customer problems
Experience working within a Hospital, Physicians Office, or Medical Clinical setting, Medical Terminology, ICD – 10 and CPT codes, Medicare and / or Medicaid Services, Call Center environment
Professional experience in a Clerical or Administrative support related role
Bilingual fluency in English and SpanishTelecommuting Requirements

Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Ability to keep all company sensitive documents secure (if applicable)
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet serviceUnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90 of our non – clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities athttps://www.unitedhealthgroup.com/newsroom/addressing-covid.html

Careers with Optum. Heres 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 worlds 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 lifes best work.SM

Colorado Residents OnlyThe hourly range for Colorado residents is $15.00 to $25.19.Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirementsHealth, dental, and vision plans wellness program flexible spending accounts paid parking or public transportation costs 401(k) retirement plan employee stock purchase plan life insurance, short-term disability insurance, and long-term disability insurance business travel accident insurance Employee Assistance Program PTO and employee-paid critical illness and accident insurance.
Diversity creates a healthier atmosphereUnitedHealth 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, Clinical, Healthcare, Administrator, UnitedHealthcare, Telecommute,work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #RPO

Requisition Number:933614

Business Segment:Enterprise Clinical Services

Employee Status:Regular

Job Level:Individual Contributor

Travel:No
Additional Locations

Phoenix, AZ, US
Hartford, CT, US
Tampa, FL, US
Minneapolis, MN, US

Overtime Status:Non-exempt

Schedule:Full-time

Shift:Day Job

Telecommuter Position:Yes