30 days old

Intake UM Coordinator San Antonio, TX - 931551

Shavano Park, TX 78231
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  • Job Code
    931551

Do you have compassion and a passion to help others?Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieveyour lifes best work.(sm)
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"WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patients health. WellMeds proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optumdivision under the greater UnitedHealth Group umbrella.
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"Under the supervision of the UM Operations Supervisor, this position is responsible for the daily coordination of UM processes in the Intake Call Center. This position serves as the initial intake of pre - service requests, claim reviews and inpatient hospital coordination and diabetic supplies. Coordinates UM processes with Medical Directors, UM Nurses, hospitals, physicians and other various departments. Provides clerical support to clinical staff in their medical necessity review process. UM Coordinator is expected to maintain production and quality standards.

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This is a call center environment near Lockhill Selma Rd/Dezavala/IH-10/Loop 1604, San Antonio, TX, 78249

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Monday- Friday: 9AM - 6PM (8HRS). Position eventually could allow for some telecommuting privileges.
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"Primary Responsibilities:

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  • Managing authorizations / notifications and other service requests received via incoming phone calls, faxes and portal submission
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  • Providing excellent customer service, including the ability to handle escalated callers
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  • Determining authorization or notification requirements
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  • Preparing authorization cases for Medical Directors, UM Nurses and Case Managers
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  • Providing administrative approvals (depends on line of business)
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  • Handling expedited authorizations, authorization updates and status checks
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  • Confirming member eligibility
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  • Responsible for outreaches to providers and/or Patient to complete authorization requests and prescriptions
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  • Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
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  • Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task
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  • Non-Clinical staff is not responsible for conducting any UM activity that requires interpretation of clinical information
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  • Performs all other related duties as assigned
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Youll 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.

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Required Qualifications:

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  • High School Diploma or GED equivalent
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  • 2 + years previous related experience in any of the following or combination thereof: healthcare, call center, and / or customer service setting using the telephone and computer as the primary instrument to perform job duties
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  • Medical Terminology
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  • Proficiency with Microsoft Office applications required, i.e Excel, Word, Outlook
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  • Ability to work the hours of 9am - 6pm Monday - Friday
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  • In and / or out - of - town travel required as deemed necessary by business need
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.
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Preferred Qualifications:

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  • Associates Degree in a healthcare related field
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  • , ICD - 9 / ICD-10 and CPT Knowledge
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Careers with WellMed.Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to doyour life's best work.(sm)

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Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

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Job Keywords:WellMed, Healthcare, Bilingual, Data Entry, Associate Patient Care Coordinator, Patient Services Rep, Patient Care Tech, Medical Office Specialist, Call Center, San Antonio, New Braunfels, Seguin, Gonzales, Shiner, Yoakum, Boerne,78249, NW Pkwy., Texas, TX

Posted: 2021-05-15 Expires: 2021-07-14

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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Intake UM Coordinator San Antonio, TX - 931551

UnitedHealth Group
Shavano Park, TX 78231

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