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 Clinical Quality Management Medical Record Clerk/ TRICARE - Phoenix, AZ - Phoenix, Arizona, United States

   
Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Existing work authorization required for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Administrative - Clerk
Administrative - Other
Health - Clinical/Medical Assistant
Customer service & support
 
Travel: Unspecified 
Accept candidates: from anywhere 
Languages: English - Fluent
 
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 521590 / Latpro-2481281 
Date posted: May-14-2013
State, Zip: Arizona, 85006

Description

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.

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.

 

This position works under the direction of the Clinical Quality Management (CQM) Medical Records Manager. The Medical Records Clerk processes requests for medical records for potential quality issues, studies, TRICARE Quality Monitoring Contractor (TQMC) requests, and other activities involving medical records. Maintains compliance with TRICARE requirements. Maintains confidentiality of all quality assurance activities and protects all personal health information (PHI) in accordance with all rules and regulations.

 

Primary Responsibilities:

  • Process requests for medical records
  •  Mail or fax requests for medical records to facilities and providers within process timelines
  • Calls facilities and  providers for status of requested documents
  •  Document and track status of all medical record requests in medical records database
  •  Files and maintains received medical records and CQM documents per file plan
  • Processes mail received in the CQM department
  • Prepare and transfer medical records to the TQMC to meet contract delivery timeline requirements
  • Processes invoices for received medical records
  •  Maintains and ensures the organization of the medical records room
  •  Archives records when appropriate and per policies and procedures
  •  Assists clinical staff with the assembly of case files
  • Performs all other duties as assigned.



Requirements

Requirements:

  • High school Diploma or GED
  • 2 + years professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties
  • 2 + years professional experience in clerical or administrator work
  • 35 wpm typing / data entry experience
  • Basic   MS/Office spreadsheets, sorting, data entry)
  • Must be able to lift up to 40lbs.
  • United States Citizenship
  • Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86

 

Assets:

  • Experience processing and maintaining files within the healthcare industry is preferred.
  • Clerical experience in healthcare quality activities is strongly desired.
  • Medical Terminology/Coding (ICD-9 and CPT) is preferred
  • Call Center with high volume is preferred
  •  Hospital, physician, or medical / clinical is strongly desired
  •  Medicare and/or Medicaid is preferred
  • Healthcare or insurance benefits is preferred
  • College degree is preferred

 

As a requirement of UnitedHealth Group’s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or “NACâ€).  Successful completion of the NAC process is a requirement for continued employment in this role.  NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense.  Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received.  Failure to obtain final NAC approval will result in termination from this role.

 

UnitedHealthcare Military & Veterans is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.

We serve those who serve our nation, providing quality health care services to millions of military beneficiaries across the (list region post award). 

Our commitment to helping people live healthier lives, and to continue the honor, satisfaction, and quality of the TRICARE military health benefit program is greater than ever. Our efforts complement the Military Health System to demonstrate the best blend of public and private health care solutions. 

It's not just business as usual. It is one of our proudest endeavors. 

If you're ready to help make health care work better for those who serve our nation. If you are smart, creative, and committed. If you want to make a difference. Consider being part of the elite team at UnitedHealthcare Military & Veterans.

This is an opportunity to share in something special; a chance for all of us to serve, to excel, and to know that we've made a difference for those families who have made our nation stronger.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth 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.


 

UnitedHealth Group requires you to fill in their application form that will open in a different window.

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