Associate Patient Care Coordinator - Referral - UnitedHealth Group

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.

Compassion is the essential trait that drives superior health care performance. But it's just a start. At OptumCare innovative thinking is just as important. Our unique team of health care providers are an emerging and important part of Optum and the UnitedHealth Group family of businesses. Our approach is designed to help physicians and other providers deliver the right care at the right time in the right setting. That takes smart ideas and incredible teamwork. And that's where you come in. In this role, you'll support a clinical team that's helping patients in new and better ways while giving them a generous helping of compassion and respect.

Urology Specialists of Nevada, part of Optum, has an immediate opening for a friendly, patient focused and detailed oriented an Associate Patient Care Coordinator-Referral.  The Associate Patient Care Coordinator - Referral is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical, and service goals.

Schedule: Monday through Friday a 40 hour work week between the hours of 7:30 am to 5:00pm

Location: 2010 Wellness Way, Suite 200, Las Vegas, NV 89106

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

What are the reasons to consider working for UnitedHealth Group?   Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. 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, Vision, 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

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 experience with insurance programs and basic managed care principles such as referrals and prior authorization

• 1+ years of knowledge of Nevada health insurance terminology

• Intermediate computer proficiency including MS Word, Excel and Outlook be able to use multiple web applications 

Preferred Qualifications:

• 1+ years of experience in a health care setting
• Knowledge/understanding of CPT/ICD-10 coding
• Ability to work in an office setting with patient contact during shift
• Experience in a high-volume medical clinic
• Work experience in Urology
• Knowledge of local HMO/PPO/Medicare plans
• Bilingual (English/Spanish)

Soft Skills:

• Excellent communication skills and phone etiquette

Nevada Residents Only: The hourly range for Nevada residents is $16.00 to $27.31 per hour. 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. 

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