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Bilingual English and Spanish Clinical Administrative Coordinator - Newark, NJ more...
Location:Newark, NJ
Company:Community and State
First posted:June 15, 2017
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Position 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 life's best work.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.

What makes your clinical career greater with UnitedHealth Group?
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.Primary Responsibilities:
Manage administrative intake of members or the admission/discharge information post notificationWork with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providersManage the referrals process, processing incoming and
outgoing referrals, and prior authorizations, including intake,
notification and census rolesReceive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triage.Review requests for adverse determination, approval notification and processing notification requirementsAssist the clinical staff with setting up documents/triage cases for Clinical Coverage ReviewHandle 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-9 and CPT coding usageCommunicating in Spanish with members

Required Qualifications:

High School Diploma / GED or higher 2+ years of Customer Service experience analyzing and solving customer's problems1+ years of experience working in an office setting
using the telephone and computer as the primary instruments to perform
job dutiesExperience using a computer and Microsoft Office (Word, Excel and Outlook)Comfortable working Monday-Friday 9:00 am - 6pm

Must be Bilingual English and Spanish and able to
communicate professionally with members

Must be able to travel 20% within the local area
Preferred Qualifications:

Healthcare experienceHealth education experienceMedical Terminology knowledgeMedicaid knowledgePrevious experience working in a CallCenter Careers at UnitedHealthcare Community & State.
Challenge brings out the best in us. It also attracts the best. That's
why you'll find some of the most amazingly talented people in health
care here. We serve the health care needs of low income adults and
children with debilitating illnesses such as cardiovascular disease,
diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based
approach considers social, behavioral, economic, physical and
environmental factors. Join us. Work with proactive health care,
community and government partners to heal health care and create
positive change for those who need it most. This is the place 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.UHG, Newark, NJ, customer service, healthcare, telephonic, patient interaction, field based, advocacy

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