Clinical Admin. Coordinator Specialty UM Technician, Optum Care Delivery/Optum CA - Ontario, CA

Company: UnitedHealth Group
Location: Ontario
Posted on: January 2, 2022

Job Description:

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.(sm)The Specialty Technician will be responsible for managing all specialty requests. Requests for Durable Medical Equipment and Home Health Care requested by physicians/vendors will be entered and/or processed based on Timeliness of UM Decisions Policy and Procedures. This position will work with closely with Medical Management staff within the network.Primary Responsibilities:

• Managing incoming specialty requests
• Performs duties as outlined in Policy and Procedures for specialty referrals
• Reviews initial clinical information to determine if additional information is necessary prior to forwarding to reviewer and ensures consistent and timely flow of authorization process
• Follows Pend and denial process per guidelines and documents system same day
• Provides eligibility, benefits, authorization history information, prescription/order, clinical information, and health plan criteria to reviewer for decision making
• Maintains lists of contacts and stays current on health plan guidelines and updates
• Follows company policy and procedures with regard to HIPAA and patient confidentiality
• Promotes and demonstrates vision, mission and values of the organization
• Incorporates patient Rights and Responsibilities in all aspects of job performance
• Organizes overall workload to complete responsibilities in a timely manner
• Performs job responsibilities within established guidelines and scope of practice
• Other duties as assignedYou'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 graduate or GED equivalent
  • 1+ years of data entry experience
  • 6+ months of experience in the medical field, either in a hospital, clinical or insurance setting that includes experience with computers
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliancePreferred Qualifications:
    • Managed care experience To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm) OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employmentJob Keywords: Medical & Clinical Operations, Clinical Admin & Processing, Ontario, CA, California

Keywords: UnitedHealth Group, Ontario , Clinical Admin. Coordinator Specialty UM Technician, Optum Care Delivery/Optum CA - Ontario, CA, Professions , Ontario, California