The Associate Clinical Administrative Coordinator is a non – clinical role in a high volume customer service environment handling inbound and outbound requests from acute members or providers via phone, email, system platforms and applications. You will be responsible for managing the intake process of members, processing admission and / or discharges, managing referrals, conducting prior authorizations, and resolving any issues and inquiries. This position will work in collaboration with hospitals, clinics, facilities, and the clinical team.
This position is full-time (40 hours / week), Thursday – Sunday. Employees are required to work any assigned 8-hour shift between the hours of 7:00 AM – 8:00 PM CST including the flexibility to work occasional overtime and weekends based on business need.
We offer up to 2 weeks of paid on-the-job training (paired with SME). The hours during training will be 7:00 AM – 5:30 PM CST from Thursday – Sunday. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Process inbound and outbound data and communication (i.e., faxes, emails and electronic communication) according to productivity and quality standards.
- Enter, review and or verify member information in the nH Coordinate care management platform and communicate approved pertinent information with healthcare providers and / or naviHealth team as needed.
- Enter the required data into the naviHealth database accurately and in a timely manner.
- Complete administrative documentation for member records including but not limited to disenrollment, transitioning, creating authorization shells, attaching documents (i.e., medical records), and logging therapy information.
- Manage inbound and outbound telephone communication in a professional manner and according to productivity and quality standards.
- Process inbound and outbound data and communication (i.e., faxes, emails and electronic communication) according to productivity and quality standards.
- Enter, review and or verify member information in the nH Coordinate care management platform and communicate approved pertinent information with healthcare providers and / or naviHealth team as needed.
- Enter the required data into the naviHealth database accurately and in a timely manner.
- Complete administrative documentation for member records including but not limited to disenrollment, transitioning, creating authorization shells, attaching documents (i.e., medical records), and logging therapy information.
- Assist in a smooth coordination of members care between health providers and the health plan.
- Establish relationships and communicate, when appropriate, to providers, clients and / or naviHealth field / care management staff as defined by departmental policy and process.
- Triage inbound calls manage member inquiries / requests, and resolve or escalates to appropriate naviHealth or health plan personnel.
- Run and / or review reports to monitor assigned team duties are completed.
- Follow chain of command as appropriate when reporting issues or concerns.
- Attend naviHealth meetings as requested.
- Adhere to organizational, departmental, compliance and regulatory policies and procedures.
- Promote a positive attitude and work environment.
- Perform other duties and responsibilities as required, assigned, or requested.
