30 days old

LHI Clinic Benefits Specialist - New York, NY - 931220

New York, NY 10007
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  • Job Code
    931220

AtOptum, the mission is clear:Help people live heathier lives and help make the health system work better for everyone

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LHIis one of 4 businesses underOptumServe. OptumServeprovides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well - being of Americans.

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By joiningOptumServeyou are part of the family of companies that makeUnitedHealth Groupa leader across most major segments in the U.S. health care system.

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LHIwas founded in 1999 and acquired byOptumin 2011,LHIspecializes in creating and managing health care programs through on - location services, patient - specific in - clinic appointments, telehealth assessments, or any combination based on customer need.LHI'scustomizable solutions serve the diverse needs of commercial customers, as well as federal and state agencies, including the U.S. Departments of Defense, Veterans Affairs, and Health and Human Services.

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There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Ready for a new path? Start doingyour life's best work.SM

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As a Clinic Benefits Specialist you will primarily work directly with patients to identify their specific needs and/or recommend adjustments to their plan of care.Additionally, the Clinic Benefits Specialist will assist patients in understanding details related to their care, explain their medical benefits/coverage specifics and/or how to access those benefits. The Clinic Benefits Specialist will provide education on the appropriate utilization of services and facilitate preferred provider decisions.

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The Clinic Benefits Specialist will also be responsible for facilitating clinic patient check-ins and the check-out process, to include face to face consultation regarding exam outcomes, program benefits and needs assessment. The Specialist will serve as the first and last point of contact for clinic patients in order to address patient needs or questions accordingly while providing a positive patient experience.

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Primary Responsibilities:

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  • Ensure proper security measures are adhered to for all clinic patient and staff
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  • Operate a multi-line phone system to answer, screen and transfer inbound phone calls
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  • Input/update patient demographic data into computer system
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  • Identify urgent member situations and escalate to next level when necessary
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  • Manage/respond constructively to challenging patient interactions (e.g., address lack of understanding, socioeconomic challenges, frustrated patients, language barriers)
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  • Utilize interviewing techniques and active listening to collect and retain member information and incorporating responses as they are presented to complete assessment
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  • Provide individualized education on preventative healthcare measures (e.g., immunization, healthcare screening)
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  • Explain and ensure understanding of details related to patient care (e.g., home health care transition procedures)
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  • Explain medical benefits/coverage specifics (e.g., procedures/amounts covered, denials of coverage, appeal rights) and/or how to access benefits
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  • Educate member on appropriate utilization of services based on need (e.g., PCP vs. ER)
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  • Facilitate member choice of preferred provider
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  • Coordinate/confirm scheduling of doctor visits/services with patients, verify referral approval
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  • Use desk top computer applications (e.g., MedNet, Excel, Word, Outlook, Office Communicator) to summarize information (e.g., reports) or communicate member information to others.
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  • Document information (e.g., assessment information, member interactions, referrals, follow up plans) in relevant computer systems.
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  • Collect, scan and upload medical records into appropriate data systems
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  • Print exam documents and review outcomes with the member
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  • Navigate multiple applications at once to obtain and/or document member information
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  • Learn updates and changes to computer systems/applications and apply to navigate applications effectively
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  • Troubleshoot computer/database issues, report IT issues for resolution
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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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  • Bachelors degree (or higher) in social work, licensed practical nurse (LPN), CNA/HHA OR High Shool Diploma / GED (or higher)with 3+ years of experience working in a health care role. Equivalent combination of education, experience and/or applicable military experience will be considered.
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  • Understanding of Federal privacy regulations (e.g., HIPAA)
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  • Knowledge of safety guidelines/practices (e.g., OSHA)
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  • Knowledge of basic medical terminology and human anatomy to document patient information using standard language/medical terminology
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  • Understanding of policies/procedures that apply to patient care
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  • Strong customer service orientation
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  • You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role
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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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PreferredQualifications:

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  • National Career Readiness Certificate
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  • Bilingual English/Mandarin
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  • Bilingual English/Cantonese
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  • Understanding of managed care practices/contract provisions to evaluate appropriateness of services (e.g.,contracted providers, financial implications, relevant regulations)
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Soft Skills:

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  • Excellent verbal communication, telephone etiquette and interpersonal skills
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  • Ability to work independently
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  • Ability to multi-task; think and act quickly in an emergency situation
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UnitedHealthGroup 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. 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. 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

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Careers with LHI.Our focus is simple. We're innovators in cost-effective health care management. And when you join our team, you'll be a partner in impacting the lives of our customers, and employees. We've joinedOptumHealth, part of theUnitedHealth Groupfamily of companies, and our mission is to help the health system work better for everyone. We're located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We're supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission-driven focus. 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: 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.

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UnitedHealth Groupis a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Keywords:Clinic, Benefits Specialist, LHI, hiring immediately, #rpo

Posted: 2021-05-26 Expires: 2021-07-11

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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LHI Clinic Benefits Specialist - New York, NY - 931220

UnitedHealth Group
New York, NY 10007

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