Job: Clinical Administrative Coordinator - Cypress, CA
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The Centralized Correspondence Unit (CCU) receives all Commercial CCR (Clinical Coverage Review) Adverse Determination (denials) cases for completion of the adverse determination notification letter (denial letter). The case is reviewed by the CCU Coordinator who validates all compliance elements using the CCU QA (Quality Assurance) Checklist. This QA Checklist has been created with feedback from CCR Senior leadership & Compliance to ensure all letters/cases meet the regulatory requirements. The productivity standard is 30 letters per day.
When you are in the business of health care, you're in the business of people. At UnitedHealth Group we want every customer experience to be distinctly personal. The challenge is complex. When people call us for help, their focus is on getting the best care possible. We help them understand their benefits and their options. This part of their lives matters a lot to them and it matters just as much to us. Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.
Skills / Requirements
- 1+ year of customer service experience required
- 2+ years of experience in a medical office environment
- 1+ year professional PC experience (Microsoft Word, Excel and Outlook) (Need to be computer savvy)
- High School diploma/GED required
- 2+ years of professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties
- Available to work Full-time, and some weekend work as needed
- 1+ year experience with CPT or ICD-9 coding preferred
- Previous employment with a Health Insurance Plan or Medical Group
- 1+ year experience with medical terminology is preferred
Physical Requirements and Work Environment:
- Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods of close vision looking at a computer monitor
- Service center environment with moderate noise level due to Representatives talking, computers, printers, floor activity
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:
UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.
UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.
UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.
Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.
Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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