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UnitedHealth Group
San Juan, Puerto Rico, United States
(on-site)
Posted
1 day ago
UnitedHealth Group
San Juan, Puerto Rico, United States
(on-site)
Job Type
Full-Time
Clinical Admin Coordinator (Determination Letters) - San Juan, PR
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Clinical Admin Coordinator (Determination Letters) - San Juan, PR
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
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. 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.The Clinical Administrative Coordinator (CAC) is a multi-faceted role within Optum Health Risk Operations that encompasses different levels of administrative support. The Clinical Administrative Coordinator serves as a bridge, allowing for a seamless transition for members and providers moving through the continuum of care. This role can include initial triage of members for possible transition to clinical staff, managing admission and discharge census information, serving as a point of contact for facilities and clinical teams, telephonic engagement with our members and providers, providing information on available network services, managing the referral process to connect members with all available resources, management of prior authorizations, and generation of written determination notifications.
The National Letter Team Letter Coordinator is responsible for drafting Notice of Action (NOA) and Notice of Extension (NOE) letters for government and commercial specific clients that adhere to the state and federal regulatory requirements. The Letter Coordinator also completes outbound calls to client-specific customers requesting the return of specific letters.
Major Responsibilities:
- Drafts NOA and NOE letters for government and commercial specific clients.
Makes outbound calls to client specific customers to initiate letter retrieval.
Adherence to client, regulatory and accreditation requirements for letter documentation.
Demonstrate product knowledge by identifying the appropriate letter template based on the services and action within the case.
Consistently meet established productivity, adherence, and quality standards.
Other duties as assigned by manager and/or director.
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:
- 1+ years of professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties OR customer service experience analyzing and solving customer problems
Healthcare experience
Experience working with Microsoft Outlook, Microsoft Word, and Microsoft Excel (ability to create, edit, save and send emails, documents and spreadsheets)
Computer experience including, but not limited to, ability to learn new computer system applications
Ability to work the hours of 08:00 am - 8:00 pm AST Monday-Friday including availability to work Saturdays from 10:00 am - 8:00 pm AST(It may be necessary, given the business need, to work Holidays, weekends and occasional overtime)
Bilingual Proficiency (English and Spanish)
- Experience working within a Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD - 10 and CPT codes, Medicare and / or Medicaid Services, Call Center environment
Professional experience in a Clerical or Administrative support related role
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.
Requisition #: 2374987
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Requirements
Job ID: 85048991

UnitedHealth Group
Insurance
California
,
United States
At UnitedHealth Group, the mission is to help people live healthier lives. To achieve this goal, we are focused on building a modern, adaptable, innovative and inclusive system of health care services. Our scale and potential to improve health makes us one of the most visible stewards of America’s vast health care system. Entrusted with both important resources and responsibilities, we are involved on a daily basis in decision-making that has life-changing consequences for millions of Americans.
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