Senior Clinical Administrative Coordinator

Texas Health Institute; Dallas, Northern (TX, KY); Hybrid; USD 57,308,000 - 103,155,000; Full time

Job summary

UnitedHealth Group seeks a Customer Service professional for a remote role within the United States. You will handle inbound calls and outbound outreach, guiding members on benefits, eligibility, and billing while documenting information accurately in our systems.

The position requires 1+ years in customer service, ability to type while listening, and the flexibility to work 7:00 am–7:00 pm CST with training and possible overtime. Training is virtual and from home.

Qualifications

• Customer service experience required.
• Must be 18 years of age or older.
• 1+ years of experience in customer service.
• All new hires will complete Customer Service training classes and be proficient in the material.
• Ability to work flexible shifts within 7:00 am – 7:00 pm CST, including training, with possible overtime and weekends.

Responsibilities

• Answer incoming phone calls from customers and identify the type of assistance needed (benefits and eligibility, billing, authorizations, EOBs).
• Ask questions and listen actively to identify questions or issues while documenting information in computer systems.
• Own the problem through to resolution on behalf of the customer in real time or with timely follow-up with the member.
• Review and research incoming healthcare claims from members and providers using multiple systems and verifying necessary data for processing (pricing, prior authorizations, benefits).
• Ensure proper benefits are applied to each claim according to policies and procedures (claims processing, grievance procedures, CMS/Medicare guidelines).
• Communicate and collaborate with members and providers to resolve issues in clear, simple language.
• Meet performance goals in efficiency, accuracy, quality, member satisfaction and attendance.

Skills

Customer service

Active listening

Typing

Healthcare benefits experience

Education

High School Diploma / GED

Job description

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Candidate needs to have Customer Service experience, can listen and type at the same time, preferred Healthcare benefits experience. Candidates will be taking inbound calls and making outbound calls.

This position is full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 7:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 1 - 2 weeks of paid on-the-job training. The hours during training will be 8:00 am - 5:00 pm CST, Monday - Friday. Training will be conducted virtually from your home

Primary Responsibilities:

• Answer incoming phone calls 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

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


• Must be 18 years of age OR older


• 1+ years of experience in customer service


• All new hires will be required to successfully complete the Customer Service training classes and be proficient of the material


• Ability to work regularly scheduled shifts within our hours of operation of 7:00 am - 7:00 pm CST including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and / OR weekends, as needed.

Preferred Qualifications:

• 1+ years of experience in an office setting, call center setting OR phone support role

Telecommuting Requirements:

• 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 employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 - $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline:

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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