Correspondence UM Coordinator - National Remote
Job title: Correspondence UM Coordinator - National Remote in Dallas, TX at UnitedHealth Group
Company: UnitedHealth Group
Job description: Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.This position is 4 days, 10 hours shift, Wednesday - Saturday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 7:00 pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.We offer weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
- Process UM notification according to standard operating procedures and job aids while meeting productivity and quality standards to include:
- TruCare queues
- Information received through Right Fax
- Information received through email
- Or any other methods of receipt (phone calls, etc.)
- Process the correct health plan letters in the system of record, if applicable verify grade level
- Process the correct health plan letters manually and document in the system of record
- Process the correct health plan letter in the preferred language
- Process overnight labels for the letters when applicable
- Process return mail retrieved from the mailroom
- Process Health Plan and QIO appeals
- Exhibits excellent communication skills while providing complete and accurate information to customers
- Requests additional or supplemental information via correspondence in order to complete UM notification requests
- Prepares administrative files for Medical Directors, UM Nurses and Case Managers
- Documents and follows-up on all assigned inventory, utilizing on-line systems and procedures, according to established guidelines
- Maintains knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
- Utilize experience and judgement to plan, accomplish goals and effectively resolve each assigned task
- Print, feed, and retrieve letters from the folding machine
- Metered mail is handled according to processes and procedures
- Attends required meetings and participates in special committees as needed
- Performs all other related duties as assigned
- High School Diploma / GED (or higher)
- Must be 18 years of age or older
- 2+ years of administrative support experience
- 6+ months of knowledge / experience with medical terminology
- Intermediate level of proficiency with Microsoft Office applications, i.e., Microsoft Excel, Access, Microsoft Word, and Microsoft Outlook
- Ability to work 4 days, 10 hours schedule, Wednesday – Saturday between the hours of 8:00 am – 7:00 Pm), It may be necessary, given the business need, to work occasional overtime or weekends.
- Certified Medical Assistant training or certification
- 2+ years of experience with prior authorization or claims
- ICD-9/ICD-10 and CPT knowledge
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
- Proven ability to work independently, with some supervision and direction from manager
- Proven exceptional ability to organize, prioritize and communicate effectively
- Proven ability to provide excellent customer service to a varied customer base
- Proven ability to navigate multiple systems
- Proven ability to work in a fast-paced environment
Expected salary: $16.88 - 33.22 per hour
Location: Dallas, TX
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