Associate Clinical Administrative Coordinator - Las Vegas, NV

    • Las Vegas, NV

Position Description

Energize your career with one of Healthcare's fastest growing companies.

You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

Under direct supervision, coordinates mental health, substance abuse and Employee Assistance Program services for members through careful telephone-based triage. Direct members to appropriate care settings within contracted network. Provide support, member satisfaction and resolution of concerns for the Utilization Management function of all members. Assist members with problem solving and support the efforts of other departments regarding retention of members through phone calls and/or meetings to resolve difficulties. Has direct contact with providers, members and third-party administrators. Documents calls in multiple systems including Facets, Macess and Pronto. Performs daily data entry tasks and individual projects as assigned.

Primary Responsibilities:

  • Process incoming member telephone calls. Each agent shall comply with customer service procedures and calls will be handled within department
  • Make available appropriate provider contact information as requested by members
  • Assist with scheduling appointments as needed. Appointments scheduled within department guidelines i.e. Routine within 2 weeks, urgent within 2 days, emergent non-life threatening with 24 hours, emergent life-threatening immediate referral to hospital/ER. Work with capitated provider networks to secure timely appointments as needed
  • Complete departmental documentation in Facets, Macess or EAP Nevada as appropriate. A Macess CSF is used for documentation at the time of all calls. Documentation may include demographics (patient & provider), description of present problem/issue(s), insurance/EAP information, services approved, disposition, DOS range, case manager assignment and letter to be generated from system
  • Data entry documentation: Callers name, author, DOS range, letter generated, provided information, insurance information and case manager assigned in 100% of cases

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)
  • Knowledge of insurance benefits
  • 2+ years customer service experience
  • Knowledge of or ability to learn and apply to job functions including but not limited to those state and federal laws and regulations applicable to the operating unit
  • Must possess computer skills, window based applications (create and edit documents in Microsoft Word and Excel) and clerical experience, accurate typing and 10 key skills, alpha, and numeric

Preferred Qualifications:
  • Basic knowledge of medical/mental health terminology, CPT and ICD9 coding
  • Prior call center experience

Soft Skills:
  • Must have good interpersonal, communication and organizational skills
  • Must have the ability to contribute to the organization's efforts to eliminate racial and ethnic disparities in organizational performance
  • Must have the ability to simultaneously process information via inbound telephone calls while accessing, communicating and noting within the required systems
  • Must have the ability to demonstrate initiative, tact and to adapt to difficult situations and changing priorities

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do 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 arerequired to pass a drug test before beginning employment.

Keywords: medical receptionist, bi-lingual, insurance billing,coding ICD-9, CP, Customer Service, Call Center

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