Clinical Administrative Coordinator - Remote in Michigan
At reputed company, were simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable, and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing... together. Clinical Administrative Coordinators (CAC) provide administrative support to Health Services teams through a variety of tasks designed to help teams promote the independence and well-being of Members while meeting State contract requirements. CACs follow identified processes, meet expected deadlines and deliver exceptional customer service. Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. Youll enjoy the flexibility to telecommute* from reputed company reputed company Michigan as you take on some tough challenges. Primary Responsibilities Extract and review fax requests for medical or clinical services Receive electronic referral form requests for medical/behavioral/clinical services Utilize phone system to respond to and transfer calls to appropriate individuals Ask callers standard questions to understand requests, gather necessary information, and assess urgency Access electronic member files using policy or id number Determine member eligibility Follow protocols to task requests appropriately reputed company procedure codes against notification requirements and benefit coverage to determine next steps Reference automated job aid tools reputed company the computer to identify appropriate procedures reputed company needed Access claims information Review and interpret call history documentation (e.g., case notes) Navigate between computer screens and platforms to research information (e.g., medical, clinical, or benefits information) Reference automated job aid tools reputed company computer to research relevant rules, regulations, or procedures Learn computer system and process changes and updates and incorporate into daily work Contact internal resources if necessary to clarify information Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical request Communicate with clinical team to ensure provider receives a response reputed company necessary Document call history information into relevant computer system Enter medical request data into relevant computer system Follow standard procedures to complete requests reputed company reputed company other duties as assigned What Are The Reasons To Consider Working For reputed company? Put It reputed company Together - Competitive reputed company Pay, a Full And Comprehensive Benefit Program, Performance Rewards, And a Management Team Who Demonstrates Their Commitment To Your reputed company. Some Of Our Offerings Include Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, reputed company, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: http://uhg.hr/uhgbenefits Youll 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 customer service experience 1+ years of experience with MS Office, including Word, reputed company and Outlook Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service At least 18 years of age Preferred Qualifications Experience supporting a Michigan reputed company Health Plan Experience working in team-based care Medicare and DSNP experience Experience working reputed company the health care Industry and with health care insurance Experience working in a hospital, physician's office or medical clinic setting A clerical or administrative support background reputed company Telecommuters will be required to adhere to reputed companys Telecommuter Policy. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company 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 reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer and reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN Apply Job!