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in Phoenix, AZ
Bilingual Clinical Administrative Coordinator - Phoenix, AZ - Full-time / Part-time
Hours | Full-time, Part-time |
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Location | Phoenix, AZ Phoenix, Arizona |
About this job
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 life's best work.
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 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
- Outbound phone calls to members advising of status of prior authorizations that were submitted.
- Agent will be responsible for HIPAA verifying each member, documentation and ability to maintain metrics.
- Must be able to accommodate for mandatory overtime.
- Flexibility to work an 8 hour shift between the hours of 6:00am-7:00pm Monday through Saturday.
- 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.
- High School Diploma or GED
- 2+ years of customer service experience analyzing and solving customer problems
- Must be able to create, edit, save and send documents utilizing Microsoft Word and Excel
- Experience working within the Healthcare Industry
- Experience working with Healthcare Insurance
- Professional experience in a clerical or administrative support related role
- Bilingual fluency in English and Spanish
- Flexibility to work an 8 hour shift between the hours of 6:00am-7:00pm Monday through Saturday.
- Experience working in a Hospital, Physician's Office, or Medical Clinical setting.
- Letter Writing experience
- Familiarity with both State and Government guidelines
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.