1+ months

Clinical Administrative Coordinator - Brentwood, TN

Brentwood, TN 37027
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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.

Primary Responsibilities: 
  • Serve as primary point of contact for providers or members regarding medical / behavioral / clinical serve or benefits
  • Extract and review fax requests for medical or clinical services
  • Receive calls requesting medical / behavioral / clinical services or benefits information (e.g, from providers or members)
  • Receive electronic referral form requests for medical / behavioral / clinical services
  • Utilize phone system to respond to and transfer calls to appropriate individuals
  • Ask callers standard questions to understand requests, gather necessary information and assess urgency
  • Access electronic member eligibility
  • Follow protocols to task requests appropriately
  • Check procedure codes against notification requirements and benefit coverage to determine next steps
  • Reference automated job aid tools via the computer to identify appropriate procedures when needed 
  • Access claims information
  • Review and interpret call history documentation
  • Navigate between computer screens and platforms to research information (e.g., medical, clinical or benefits information)
  • Take calls and questions from members and/or providers regarding case status
  • Determine whether authorization are required for requested medical services
  • Reference automated job aid tools via computer to research relevant rules, regulations or procedures
  • Learn computer system and process changes and updates and incorporate into daily work
  • Contact internal resources if necessary to clarify information
  • Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical requests
  • Provide / explain benefit information
  • Provide / explain authorization information to members / providers
  • Communicate with clinical team to ensure provider receives a response when necessary
  • Document call history information into relevant computer system
  • Enter medical request data into computer
  • Follow standard procedures to complete requests
  • Request medical review via relevant computer system as needed
  • Review and advise member/provider status of a request
  • Schedule appointments for members based on request
  • Provide\ information regarding appointments and medical services to facilities staff to assist members 
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.
Posted: 2019-11-13 Expires: 2020-02-16

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Clinical Administrative Coordinator - Brentwood, TN

UnitedHealth Group
Brentwood, TN 37027

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