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.
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. *Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.
The challenge here lies in managing a full range of tasks - many of them routine in nature without sacrificing quality.
- Draft letters for government and commercial specific clients
- Gain knowledge of the State and Federal regulations concerning the services and benefits
- 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
You’ll 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.
- High School Diploma / GED (or higher)
- 2+ years of professional experience in an office / customer service setting
- 1+ years of experience with Medical Terminology
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.
- Bachelor's Degree (or higher)
- Experience working within the healthcare industry, Hospital, Physician's office or medical setting and / or a call center environment
- Knowledge of ICD - 9 and CPT codes and Medicare / Medicaid services
- Basic / foundational proficiency with Microsoft Word (creating, saving, formatting documents) and Microsoft Outlook (ability to open and send emails)
- Flexibility to work outside standard business hours
- Bilingual fluency in English and Spanish
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.
Keywords: Clinical, Administrative, Coordinator, Iselin, NJ