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Senior Clinical Administrative Coordinator - Las Vegas, NV

Company: UnitedHealth Group
Location: Las Vegas
Posted on: November 22, 2021

Job Description:

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. SM Let's face it, no industry is moving faster than health care. And no organization is better positioned to move health care forward than UnitedHealth Group. We're out to use data, technology and people in ways that help drive change and make the health care system work better for everyone. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive. Take this opportunity to work with a Fortune 10 industry leader. Under supervision, the Senior Clinical Administrative Coordinator assists in reviewing and directing daily work load. Performs duties in support of the Utilization Management department in accordance with company policies, state and federal laws applicable to the operating unit. Acts as a resource for complex issue resolution. Assists in developing and maintaining efficient and effective processes. Responsible for initiation of cases by data entry of clinical into the Facets system, via telephone, fax or computer. Electronically routes cases to the nurse for review and decision. After decision, is responsible for accurate case completion to include generation of approval letters while staying within compliance with time frames. Communicates with providers other departments as needed. Works independently with minimal supervision. 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 8:00 AM - 5:00 PM PST from Monday - Friday. It may be necessary, given the business need, to work occasional overtime. Our office is located at 2716 North Tenaya Way Las Vegas, NV, 89128Primary Responsibilities:

  • Follow departmental policy regarding accurate documentation of clinical data, demographic and product information, provider / facility contract status; appropriately route cases to RN for clinical review; follow department policy for non-clinical level notifications.
  • Process member requests; including contacting member and provider's office as needed for case processing. Outcome is scanned into Macess and case is routed back to member service.
  • Problem solves complex issues related to prior authorizations cases
  • Exercises a proactive approach in identifying trends relating to Facets case accuracy.
  • Provide high level of customer service while communicating with members, internal departments and provider office staff as pertains to performance of job responsibilities.
  • Part of the challenge here is dealing positively with members and providers in sometimes challenging circumstances. As a subject matter expert, you'll also be the "go-to" resource for information. The flexibility to work evening hours will also be required.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)
    • 2+ years of experience in a Healthcare facility, Medical Office, Hospital OR Managed Care setting
    • Previous experience training others
    • Experience with Medical Terminology
    • Experience with ICD-10 / CPT coding
    • Experience using a computer and Microsoft Office - Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
    • Ability to work any 8-hour shift between the hours of 8:00 AM - 5:00 PM PST from Monday - Friday, including the flexibility to work occasional overtime, weekends, and holidays based on business need
    • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance. Preferred Qualifications:
      • 3+ years of experience in a Healthcare facility, Medical Office, Hospital OR Managed Care setting
      • Prior Authorization and / or DME - Durable Medical Equipment experience
      • Previous experience working in a Call Center UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status. Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work. SM Nevada Residents Only: The salary range for Nevada residents is $18.80 - $33.41. 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 incentivesDiversity 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.Keywords: Admin, medical coding, CPT, office, receptionist, administrator, administrative, medical, healthcare, call center, phones, paperwork, UHG, customer service, healthcare, telephonic, patient interaction, advocacy , hiring immediately, #RPO

Keywords: UnitedHealth Group, Las Vegas , Senior Clinical Administrative Coordinator - Las Vegas, NV, Healthcare , Las Vegas, Nevada

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