Associate Patient Care Coordinator-Benefits and Eligibility
Company: UnitedHealth Group
Location: Las Vegas
Posted on: May 26, 2023
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Job Description:
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. - Come make an impact on
the communities we serve as we help advance health equity on a
global scale. Here, you will find talented peers, comprehensive
benefits, a culture guided by diversity and inclusion, career
growth opportunities and - your life's best work. SM
Primary Responsibilities:
Provide high level of customer service while communicating with
internal departments and external provider office staff as pertains
to performance of job duties
Review and process prior authorization requests to meet
departmental key indicator productivity
Verifies patient insurance eligibility & benefits to include
applicable co-pays, co-insurances, deductibles, Out of Pocket
Maximum, appropriate service facilities, services covered and which
services if any require prior authorization
Demonstrate knowledge of insurances including navigating websites
for online benefit reviews
Answer incoming calls regarding benefits, eligibility,
authorizations & referrals as well as other inquiries as it relates
to health insurance and acts as Patient Advocate
Process adverse determinations; timely notification and thorough
documentation
Respond to complex customer calls
Resolve customer service inquiries which could include:
Benefit and Eligibility information
Authorization for treatment
Specialists Orders/Referrals
Must be able to work independently
Submit Specialists Referrals with appropriate clinical information
using established protocols & procedures
Exceed attendance standards set by company policy
Take responsibility of problem solving
Any other duties that may arise
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)
1+ years of benefits and eligibility experience
Intermediate level of proficiency with -Microsoft -Outlook, Word,
and Excel
Full COVID-19 vaccination is an essential job function of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements. UnitedHealth
Group will adhere to all federal, state and local regulations as
well as all client requirements and will obtain necessary proof of
vaccination, and boosters when applicable, prior to employment to
ensure compliance. Candidates must be able to perform all essential
job functions with or without reasonable accommodation.
Preferred Qualifications:
Experience in a high-volume medical clinic
Work experience in Urology
Knowledge of Nevada health insurance terminology
Knowledge of local HMO/PPO/Medicare plans
Bilingual (English/Spanish)
To protect the health and safety of our workforce, patients and
communities we serve, UnitedHealth Group and its affiliate
companies require all employees to disclose COVID-19 vaccination
status prior to beginning employment. In addition, some roles and
locations require full COVID-19 vaccination, - including boosters ,
as an essential job function. UnitedHealth Group adheres to all
federal, state, and local COVID-19 vaccination regulations as well
as all client COVID-19 vaccination requirements and will obtain the
necessary information from candidates prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation. Failure to meet
the vaccination requirement may result in rescission of an
employment offer or termination of employment.
Careers with Optum. - Our objective is to make health care simpler
and more effective for everyone. With our hands at work across all
aspects of health, you can play a role in creating a healthier
world, one insight, one connection and one person at a time. We
bring together some of the greatest minds and ideas to take health
care to its fullest potential, promoting health equity and
accessibility. Work with diverse, engaged and high-performing teams
to help solve important challenges.
Nevada Residents Only: - The hourly range for Nevada residents is -
$16.00 to $27.31 . 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.
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.
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.
#RPO #RED
Keywords: UnitedHealth Group, Las Vegas , Associate Patient Care Coordinator-Benefits and Eligibility, Other , Las Vegas, Nevada
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