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 achieve your life’s best work.(sm)
WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient’s health. WellMed’s proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella.
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.
This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 7:00am – 6:00pm CST. It may be necessary, given the business need, to work occasional overtime or weekends. Training will be conducted virtually from your home.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Managing authorizations / notifications and other service requests received via incoming phone calls, faxes and portal submission
- Providing excellent customer service, including the ability to handle escalated callers
- Determining authorization or notification requirements
- Preparing authorization cases for Medical Directors, UM Nurses and Case Managers
- Providing administrative approvals (depends on line of business)
- Handling expedited authorizations, authorization updates and status checks
- Confirming member eligibility
- Outreaches to providers and/or Patient to complete authorization requests and prescriptions
- Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
- Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task
- Non-Clinical staff is not responsible for conducting any UM activity that requires interpretation of clinical information
- Performs all other related 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 / GED (or higher)
- 2+ years of combined or related experience in a healthcare, call center, and/or customer service setting using the telephone and computer as the primary instrument to perform job duties
- Ability to work the hours of 9:00am - 6:00pm CST, Monday - Friday
- Proficiency with Microsoft Office Word (create and maintain documents), Excel (create and maintain spreadsheets) and Outlook(email and calendaring)
- Associate’s Degree (or higher) in a healthcare related field
- Medical Terminology
- ICD-9/ICD-10 and CPT Knowledge
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Ability to keep all company sensitive documents secure (if applicable)
- Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
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 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 do your life's best work.(sm)
Colorado Residents Only: The 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. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
*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.
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