The Care Team Associate (CTA) for prior authorization department will effectively support the successful implementation and execution of all Utilization Management programs and processes.
The Care Team Associate will provide support to the Utilization Management staff to ensure applicable program processes and operational responsibilities are met. The CTA will prepare the authorization by seeking out medical records to the providers via phone or fax, and once completed it is sent to the nurse for review. This position will also provide support in troubleshooting any authorization related issues identified by the Medical Management staff. This position will also assist with training and orientation of new staff and will serve as a subject matter expert for existing staff to ask questions.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges
- Receives and responds to inquiries from all communication venues: e.g. phone, queue, department e-mail box or fax.
- Coordinates and assists initial screening of prior authorization requests via all communication venues; as well as administrative preparation for clinical staff.
- Exhibits excellent phone and communication skills while providing complete and accurate information to customers.
- Requests additional or supplemental information via correspondence in order to complete prior authorization requests.
- Completes prior authorizations in the WellMed prior authorization system according to approved policies and procedures.
- Compiles and reports data for ongoing key performance indicators and summarizes and presents findings to departmental leadership. Notifies manager of trends they observe.
- Adheres to assigned schedule and quality metrics.
- Provides clerical and/or administrative support to clinical staff and managers for special studies, projects and reports.
- Provides excellent customer service by serving as a resource to all internal and external customers.
- Attends required meetings and participates in special committees as needed.
- Assists with training and onboarding of Utilization Management Care Team Associates
- May act as a team lead for projects and departmental initiatives as assigned.
- Performs other duties as assigned.
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.
- High School Diploma or GED
- 2 + years of administrative support experience
- 1+ years of experience in a healthcare setting
- Must be able to work independently with some supervision and direction from manager
- Must possess excellent organizational skills, customer service skills, and verbal and written communication skills
- Must comply with all organizational and department policies regarding ethical business practices
- Certified Medical Assistant training or certification
- 2 + more years of experience with prior authorization or claims
- General knowledge of medical terminology including CPT, and ICD-10
- Working knowledge of Microsoft Office, Internet and e-mail
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
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 380,000+ 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 do your life's best work.(sm)
Colorado Residents Only: The salary/hourly range for Colorado residents is $15.00 to $25.19. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
Job Keywords: healthcare, insurance, ICD9, CPT, call center, data entry, telecommute