Position Description:When you are in the business of health care, you're in the business of people. At UnitedHealth Group we want every customer experience to be distinctly personal. The challenge is complex. When people call us for help, their focus is on getting the best care possible. We help them understand their benefits and their options. This part of their lives matters a lot to them and it matters just as much to us. Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.
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:
Respond to incoming provider and enrollee calls
Resolve customer service inquiries which could include:
Enter notifications, Providers status of an existing notification and determining if notification is required.
Complete notification wizard along with ICD-9 and CPT coding
Provide excellent customer service to both providers and enrollees
Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
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.
Qualifications:
Requirements:
HS Diploma/GED
Bilingual Skills - need to be able to speak Spanish
Ability to work independently with minimal supervision
Intermediate proficiency with MS Office - (Excel)
Accurate data entry skills
Assets:
Any prior experience working with Medicaid members population
Any experience working with Share Point
Any experience working with Careone or Facets
Any experience working with other claims systems or medical records
Any experience working with claims or billing in a providers office
Ability to read or write in Spanish, or any other language.UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach. This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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