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UnitedHealth Group Clinical Administrative Coordinator - US Remote in Dallas, Texas

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, UnitedHealthGroup 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.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 8:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

What we do defines who we are. Take a deeper look at how we're providing support during this global health crisis and search for a way you can get involved. View our Covid - 19 Resources Page at: https://info.uhg.com/

Primary Responsibilities:

  • Respond to Incoming Provider and Enrollee calls

  • Resolve Customer Service inquiries

  • Provide excellent Customer Service to both Providers and Enrollees

  • Meet established productivity, schedule adherence, and quality standards while maintaining good attendance

  • Receive Care Coordination notification cases for non - clinical assessment / intervention and provides appropriate triage

  • Process out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate products

  • Process notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issues

  • Determine benefit coverage issues based on employer group contracts

  • Set up / document / triage cases for (CCR) Clinical Coverage Review

  • Ensure all potential member needs are identified and forwarded to the appropriate Care Coordinator for risk validation when applicable

  • Process letters within DOL time frames

  • Verify appropriate ICD - 10 and CPT coding usage

  • Communicate to providers and members benefit determinations within DOL time frames

  • 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

  • Other duties as assigned by manager and / or director

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.

Required Qualifications:

  • High School Diploma / GED (or higher)

  • Healthcare experience

  • 1+ years of professional experience in an office / customer service environment

  • Experience working with Microsoft Outlook, Microsoft Word, and Microsoft Excel (ability to create, edit, save and send emails, documents and spreadsheets)

  • Computer experience including, but not limited to, ability to learn new computer system applications

  • Ability to work Tuesday - Saturday, Sunday - Thursday, or Monday - Friday between 8:00 am - 6:00 pm (40 hrs per week)

  • Flexibility to work outside standard hours of operations due to changing business needs

  • Must have a quiet designated work space and access to install secure high speed internet (minimum speed 1.5 download mps and 1 upload mps) via cable / DSL in home (NOTE: wireless / cell phone provider, satellite, microwave, etc...does NOT meet this requirement)

  • You will be required to adhere to UnitedHealth Group’s USTelecommuting Policy

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app,Interactive Voice Response (i.e., entering your symptoms via phone system) orsimilar UnitedHealth Group-approved symptom screener. When in a UnitedHealthGroup building, employees are required to wear a mask in common areas. In addition,employees must comply with any state and local masking orders

Preferred Qualifications:

  • Bachelor's Degree (or higher)

  • Professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties OR customer service experience analyzing and solving customer problems

  • Experience working within a Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD - 10 and CPT codes, Medicare and / or Medicaid Services, Call Center environment

  • Professional experience in a Clerical or Administrative support related role

  • Bilingual fluency in English and Spanish

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography - specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

Some of the steps we’ve taken to ensure employee well - being include:

  • Transitioned our new hire training classes to be conducted virtually

  • Launched our ProtectWell app and UnitedCARES program to help ease the burden and stress for our UnitedHealth Group team members and their immediate family affected by COVID - 19

  • Daily updates from our CEO Dave Wichmann to support and inspire team members during this challenging time

  • Onsite social distancing and increased sanitization measures for employees who have been welcomed back to our offices

  • Fully cover the COVID - 19 healthcare costs for our employees

  • Employees who self - identify as high risk or who live with someone who is high risk have been asked to remain working from home

You can learn more about all we are doing to fight COVID - 19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

UnitedHealth Group is working to create the Healthcare system of tomorrow and you can help. Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high - performance Healthcare system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed. Join with us and start doing your life’s best work. SM

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.

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