Senior Clinical Administrative Coordinator

UnitedHealth Group Inc.•Overland Park, KS

33d•$20 - $36•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, dataâ¯and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefitsâ¯and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimizationâ¯on a global scale. Join us to start Caring. Connecting. Growing together. This position is full-time (40hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:00am - 8:00pm CST, (50% of shifts will be evening). It may be necessary, given the business need, to work occasional overtime. We offer 1 to 2 weeks of paid training. The hours during training will be 7:00am to 4:00pm CST, Monday - Friday. 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.

Requirements

1+ years of prior experience in an office setting, call center setting or phone support role
Ability to manage a high volume of inbound calls, varying from 30-80 calls per day
Ability to work regularly scheduled shifts M-F within our hours of operation of 7:00am - 7:00pm CST including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work overtime and/or weekends, as needed
Ability to multitask
Must be 18 years of age OR older
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Responsibilities

Answer incoming phone calls (Around 30-80 inbound calls daily) from customers and identify the type of assistance the customer needs (i.e., benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
Review and research incoming healthcare claims from members and providers (doctors, clinics, etc.) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g., pricing, prior authorizations, applicable benefits)
Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan, documents/certificates)
Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance