16 days old

Medicare Advantage Outreach Coordinator - Albuquerque, NM - 922464

Albuquerque, NM 87102
  • Job Code
    922464

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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to doyour life's best work.(sm)

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The Outreach Coordinator Provides direct customer service for assigned departments to include but not limited to referrals, scheduling, verifying insurance, obtaining and processing patient data, and obtaining pre-certification for necessary referrals/procedures that require prior authorization. Handles customer account transactions, provides customer assistance, and interfaces with multiple clinics. Adheres to policies, procedures and regulations to ensure compliance and patient safety.Participation in Compliance and other important training is a condition of employment

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Primary Responsibilities:

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  • Provides direct customer service for assigned departments to include but not limited to obtaining referrals, reviewing referral worklists to include reviewing patients referred outside of the group for selected specialties, scheduling and verifying insurance
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  • 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
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  • Performs electronic eligibility verification, updating patient demographics, ensure required referrals and prior authorization are in place for patient visit
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  • Answer questions from patients regarding the status of their scheduled appointments. Mail fax, or communicate appropriate records, certification and authorizations to appropriate persons for the completion of scheduling
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  • Explain the process of the CWC wellness visit to patient including, but not limited to what is involved, who the provider is, and the location of the specialist office. Ability to directly schedule patients into all listed clinics to ensure a seamless transition for patients
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  • Responsible for obtaining expert level knowledge of the inter-workings of various insurance plans especially Medicare Advantage plans
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  • Responds effectively to incoming patient calls and communicates pertinent information to physician or designee to provide for continuity and optimal care
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  • Attends departmental meetings and provides constructive recommendations for areas of improvement
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  • Appropriately communicates physician orders and instructions to patients
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  • Documents pertinent patient information in the electronic medical record as it relates to job function
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  • Coordinates with various providers, team members and outreach team regarding any scheduling guidelines
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  • Meets established productivity, schedule adherence, and quality standards
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  • Other duties as assigned
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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.

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Required Qualifications:

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  • High School Diploma or GED equivalent
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  • 1 year of related experience
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  • Experience with MS Word, Excel and Outlook
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  • Knowledge of medical terminology
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  • You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role.
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
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Preferred Qualifications:

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  • Bilingual
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  • Experience working within the health care Industry and with health care insurance
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  • Experience working in a hospital, physician's office or medical clinic setting
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  • A clerical or administrative support background
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  • Excellent communication, organization and customer service skills
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  • Self-motivated, strong computer skills
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  • Proven ability to problem-solve
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  • Strong attention to detail
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  • Ability to manage time effectively and work independently
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Careers with Optum.Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to doyour life's best work.(sm)

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Coordinator, healthcare, customer service, Albuquerque, NM, New Mexico

Categories

Posted: 2021-04-01 Expires: 2021-05-01

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Medicare Advantage Outreach Coordinator - Albuquerque, NM - 922464

UnitedHealth Group
Albuquerque, NM 87102

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